B-Cell Malignancy Provides Economic Burden to US Commercial Payers

05/30/17

The high economic burden of B-cell malignancies on US commercial insurers may impact future reimbursement decisions, according to research that will be presented at the 2017 ASCO Annual Meeting (June 2-6, 2017; Chicago, IL).

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Current estimates suggest acute myeloid leukemia (AML) comprises 25% of acute leukemia cases in adult patients worldwide. In the US, estimated 5-year survival rate for patients with AML is 26%. In order to reform reimbursement policy among commercial payers, up-to-date statistics on the clinical and economic burden of AML among insured patients is needed.

May Hagiwara, PhD, Policy Analysis Inc (Brookline, MA), and colleagues conducted a retrospective study to assess the burden of AML in a US commercially insured population. IMS PharMetrics Plus health insurance claims database was used to collect data from 26,344 adult patients with at least 1 claim of AML from 2008 to 2015. Patients with only 1 outpatient claim with a diagnosis of AML not in relapse or remission were excluded from the cohort.

Annual incidence and total AML-related inpatient and outpatient health care costs per person year were calculated by age and gender. Patients with newly diagnosed AML were assessed for cost analyses.

Researchers reported that the study cohort covered 228.3 million person years of enrollment. Incidence rate was calculated at 4.9 per 100,000 person years, with the greatest proportion in mean and patients aged 60 years or older. Prevalence was reported at 12.2 per 100,000 persons.

Additionally, among the 11,170 newly diagnosed patients with AML, total average costs were estimated at $352,138 per person years. Approximately 63% of costs were for AML-related care, 70% of which were in the inpatient setting.

Characteristics associated with higher costs included gender (men), age (45-49 years), and time after initial diagnosis (within the first 6 months).

Authors of the study concluded that “Although AML is relatively rare, its economic burden to US commercial insurers is substantial.” The findings of this study will serve as informative data for future reimbursement decisions by payers.—Zachary Bessette

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