Real-world economic burden of hematopoietic cell transplantation among a large US commercially insured population with hematologic malignancies Journal Article


Authors: Bonafede, M.; Richhariya, A.; Cai, Q.; Josephson, N. C.; McMorrow, D.; Garfin, P. M.; Perales, M. A.
Article Title: Real-world economic burden of hematopoietic cell transplantation among a large US commercially insured population with hematologic malignancies
Abstract: Aims: Approximately 20,000 hematopoietic cell transplantation (HCT) procedures are performed in the US annually. This study aims to study the healthcare resource utilization and costs among commercially-insured patients with hematologic malignancies who received autologous HCT (auto-HCT) and allogeneic HCT (allo-HCT) in the US. Materials and methods: Adult patients with hematologic malignancies undergoing auto- or allo-HCT between January 1, 2011 and June 30, 2014 were identified in the Truven Health MarketScan Research Databases. Patients with 12 months of continuous pharmacy and medical enrollment pre- and post-HCT were included. Patients with prior HCT were excluded. Controls were selected from patients without any claims for HCT and matched with HCT recipients in a 3:1 ratio based on age, gender, insurance type, and Deyo-Charlson Comorbidity Index categories. Total healthcare resource uses and costs were compared between auto- or allo-HCT recipients and controls. Results: In total, 10,527 patients (HCT, n = 2,672 vs control, n = 7,855) were included, with the majority of HCT recipients (63.6%) undergoing auto-HCT. During the 6-month pre-index and 12-month post-index period, auto-HCT recipients incurred $313,562 (p <.01) higher all-cause costs than controls, attributable to inpatient admission (54.1%), outpatient services (33.4%), and prescriptions (12.5%). The all-cause costs for allo-HCT recipients were $621,895 (p <.01) higher vs controls during the 18-month observation period, attributable to inpatient admissions (75.5%), outpatient services (22.1%), and prescriptions (2.4%). Conclusions: The use of HCT among patients with hematologic malignancies is associated with considerable economic burden in direct healthcare costs in a commercially insured population. Incremental costs for HCT recipients were mainly driven by costs related to hospitalization and other medical services. © 2017 Informa UK Limited, trading as Taylor & Francis Group.
Keywords: adult; controlled study; middle aged; myelofibrosis; antibiotic agent; major clinical study; myeloproliferative disorder; united states; cancer patient; multiple myeloma; cohort analysis; antifungal agent; immunoglobulin; retrospective study; health care cost; health care utilization; health insurance; prescription; length of stay; hematologic malignancy; myelodysplastic syndrome; radiology; laboratory test; ambulatory care; hospital patient; allogeneic hematopoietic stem cell transplantation; hospital admission; antivirus agent; outpatient care; graft recipient; autologous hematopoietic stem cell transplantation; resource management; hematopoietic cell transplantation; acute myeloid leukemia; health maintenance organization; disease burden; charlson comorbidity index; economic burden; human; male; female; article; healthcare resource utilization; administrative claims (health care); preferred provider organization
Journal Title: Journal of Medical Economics
Volume: 20
Issue: 12
ISSN: 1369-6998
Publisher: Taylor & Francis  
Date Published: 2017-12-02
Start Page: 1244
End Page: 1251
Language: English
DOI: 10.1080/13696998.2017.1364648
PROVIDER: scopus
PUBMED: 28782449
DOI/URL:
Notes: Article -- Export Date: 2 January 2018 -- Source: Scopus
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  1. Miguel-Angel Perales
    918 Perales