Estimation of economic costs associated with transfusion dependence in adults with MDS
- 25 June 2009
- journal article
- Published by Informa Healthcare in Current Medical Research and Opinion
- Vol. 25 (8), 1941-1951
- https://doi.org/10.1185/03007990903076699
Abstract
Objective: To examine the economic burden of myelodysplastic syndromes (MDS) and the incremental cost of transfusion dependence. Research design and methods: Adults with evidence of MDS were identified between 05/01/2000 and 09/30/2003 from a longitudinal, retrospective claims database for a large, geographically diverse US health plan and their medical histories were followed for at least 6 months. Patients were classified as transfusion-dependent (MDS-TD) or transfusion-independent (MDS-TI). Main outcome measures: Variables were categorized as demographic, health status, utilization, or cost. Utilization (inpatient hospitalizations, outpatient facility visits, emergency department visits, and physician office visits) is reported as the mean and median numbers of each specified encounter per subject. Costs were measured as the sum of patient and plan liability. All variables were analyzed descriptively, and appropriate statistical tests were used to compare the MDS-TD and MDS-TI cohorts. Pharmacy, medical, and total health care costs, adjusted for demographics and comorbidity, were estimated using gamma regression with a log link. Results: The MDS-TI cohort consisted of 2864 patients, and the MDS-TD cohort comprised 336 patients. Mean age for the entire study sample was 70.2 years. The MDS-TI cohort tended to receive most of its medical care at physicians’ offices, whereas the MDS-TD cohort received nearly as much medical care at outpatient facilities (e.g., infusion clinics, hospital outpatient clinics) as it did in physicians’ offices. The MDS-TD cohort had significantly higher mean annual costs: pharmacy, $4457 vs. $2926; medical, $50,663 vs. $17,469; total, $51,066 vs. $19,811 (p < 0.001 for all comparisons). Thus, transfusion dependence was associated with an incremental cost of $31,255 per patient per year. Some limitations inherent to using claims data and diagnosis codes for research apply to this study. Conclusions: This study demonstrated that an important consequence of transfusion dependence for MDS patients was markedly greater use of, and consequently higher costs associated with, inpatient and outpatient services. Continued research and efforts to develop biologic and pharmaceutical therapies may help more patients achieve transfusion independence, thereby reducing the financial burden of MDS.Keywords
This publication has 13 references indexed in Scilit:
- Prognostic Factors and Life Expectancy in Myelodysplastic Syndromes Classified According to WHO Criteria: A Basis for Clinical Decision MakingJournal of Clinical Oncology, 2005
- Efficacy of Lenalidomide in Myelodysplastic SyndromesNew England Journal of Medicine, 2005
- The societal unit cost of allogenic red blood cells and red blood cell transfusion in CanadaTransfusion, 2004
- Health, economic, and quality-of-life effects of erythropoietin and granulocyte colony-stimulating factor for the treatment of myelodysplastic syndromes: a randomized, controlled trialBlood, 2004
- The cost of allogeneic red blood cells – a systematic reviewTransfusion Medicine, 2003
- The myelodysplastic syndrome(s): a perspective and review highlighting current controversiesLeukemia Research, 2002
- Cost of Outpatient Blood Transfusion in Cancer PatientsJournal of Clinical Oncology, 2000
- Long-term blood product transfusion support for patients with myelodysplastic syndromes (MDS): cost analysis and complicationsLeukemia Research, 1999
- Quality of life and psychosocial adjustment in patients with myelodysplastic syndromesLeukemia Research, 1998
- Life expectancy in primary myelodysplastic syndromes: A prognostic score based upon histopathology from bone marrow biopsies of 569 patientsEuropean Journal of Haematology, 1994