Washington, DC—Hematopoietic-cell transplants (HCTs) for patients with hematologic malignancies require substantial all-cause healthcare resource utilization in the period before the hospitalization and in the 12 months after the procedure, according to a study presented at the 2016 International Society for Pharmacoeconomics and Outcomes Research annual meeting.
A wide range of costs have previously been reported for HCT, and because of differences in study designs and settings, comparisons across studies are limited, noted Machaon Bonafede, PhD, MPH, Senior Director of Outcomes Research, Truven Health Analytics, Cambridge, MA, and colleagues.
This retrospective analysis used administrative claims data for commercially insured adults (mean age, 54.2 years) with hematologic malignancies who were undergoing autologous or allogeneic HCT for the first time between January 1, 2011, and December 31, 2013. To be eligible for the study, patients were required to be continuously enrolled for the 12 months before and the 12 months after the transplant.
Of the 2516 patients identified, 1513 (60.1%) underwent an autologous HCT and 1003 (39.9%) received an allogeneic HCT. The average 2-year all-cause cost for patients who received autologous HCT was $425,828, which included the pre-HCT and post-HCT costs of $193,650 and $232,178, respectively. The average 2-year all-cause cost for patients who received allogeneic HCT was $784,014, including pre-HCT and post-HCT costs of $288,344 and $495,670, respectively.
The all-cause costs before the HCT averaged $231,399, with 51.2% of the costs resulting from outpatient services.
Hospitalization-related expenses accounted for 71.5% of the post-HCT costs. Patients who underwent autologous HCT had an average of 1.6 hospitalizations with 18 days per admission during the post-HCT period, which included being admitted for the initial HCT; patients who underwent allogeneic HCT had 2.5 hospitalizations with 23 days per admission. Other notable post-HCT expenses included outpatient services (21.2%) and outpatient pharmacy costs (7.4%).
Among 13.7% of the patients who died within the 12 months after undergoing HCT, the total healthcare costs were considerably higher than for the patients who were alive ($541,548 vs $304,748, respectively).
Because the analysis did not include indirect costs, such as caregiver burden or productivity loss, the researchers noted that the HCT costs in their study are underestimated.
“Although the current study did not assess trends in the use of HCT, it was observed that the annual number of HCTs continued to increase every year, suggesting an increased economic burden of SCT [stem-cell transplantation]; thereby, further research should focus treatments that can potentially alleviate the significant costs associated with HCT,” concluded Dr Bona-fede and colleagues.
