Health Care Resource Utilization and Cost in Patients with Chronic Myeloid Leukemia in a Privately Insured Patient Population in the United States,

To estimate health care resource use and related costs in patients with chronic myeloid leukemia (CML).

A retrospective cohort analysis was conducted using the Thomson Reuters MarketScan Commercial Claims and Encounters and Medicare Supplemental databases, which is composed of medical and pharmacy claims for approximately 43 million beneficiaries. Cases with at least 2 medical claims associated with a diagnosis of CML (ICD-9-CM code: 205.1) between Jan 1, 2002 and Dec 31, 2009 were extracted from the database. Index date was defined as the date of the first diagnosis of CML. A minimum of six months pre-index and 12 months post index enrollment was required. Disease and non-disease related utilization and costs were estimated. Resource utilization was calculated from index date to last available claims data point and then annualized per patient.

A total of 2583 patients were identified with an average follow up of 2.7 years. The mean age of the cohort was 59 years, and 45% were female. Proportions of patients having at least one inpatient, outpatient, and ER CML related visit were found to be 32.4%, 94.9%, and 15.1%, respectively. The average number of visits (standard deviation [SD]) per patient year was found to be 1.3 (1.4) and 1.6 (2.4) for inpatient and ER visits, respectively, among patients who had at least one visit. Average number (SD) of outpatient and office visits per patient year was found to be 40.6 (34.5) and 15.3 (11.6), respectively. Average number of prescriptions filled for CML was 3.3 per patient year. Disease-related health care costs ($23,166) constituted 36% of the total health care costs ($64,441) per patient year. Inpatient ($24,462 ± 77,429), outpatient ($24,391 ± 48,439), and prescription drug costs ($15,588 ± 18,327) accounted for 38%, 38%, and 24% of the total health care costs, respectively. CML drug costs accounted for 73% of the prescription drug costs.

Cost burden of chronic myeloid leukemia are substantial. Effective disease management could help reduce resource utilization and cost while improving overall disease outcomes.

Iyer:Pfizer: Employment. Trask:Pfizer Inc (at time of work completion): Employment; Sanofi: Employment. Mardekian:Pfizer Inc: Employment, Equity Ownership.