Few analyses to date have assessed the long-term costs associated with the management of chronic myeloid leukemia (CML). At ASH 2011, Shrividya Iyer, PhD, of Pfizer, presented results of a retrospective analysis performed by a group of researchers at Pfizer and the Eliassen Group that looked at information from the Thomson Reuters MarketScan Commercial Claims and Encounters Database, and the Medicare Supplemental Database. Medical claims for the years 2002-2009 were used for 2583 patients with CML who had ≥2 claims associated with a CML diagnosis.
Costs for the entire CML cohort were analyzed first, followed by a subanalysis of costs related to patients with ≥4 years of postdiagnosis follow-up. The average follow-up for the entire cohort of 2583 patients was 2.7 years, with 509 (20%) patients having ≥4 years of follow-up (mean age, 59 years). More than 50% of the patients had a point-of-service health plan with capitation coverage.
The proportion of patients with ≥1 CML-related outpatient, inpatient, or emergency department visit annually were:
- 94.9% for outpatient visits (55.1 actual outpatient and office visits combined, per patient-year)
- 32.4% for inpatient visits (1.3 average number of actual visits)
- 15.1% for emergency department visits (1.6 visits).
The average number of drug prescriptions for the entire CML cohort was 6.7 annually, with the tyrosine kinase inhibitor (TKI) imatinib accounting for 85% of those claims.
The average annual costs for CML-related healthcare utilization per patient were:
- $24,391 for outpatient care
- $24,462 for inpatient care
- $15,588 for prescription drugs (CML drugs accounted for 73% of overall prescription costs).
Data for patients with ≥4 years of follow-up indicated an increase in outpatient visits, but with nearly equivalent rates for inpatient and emergency department care; for patients with ≥1 CML-related visit, 98% had an outpatient visit, 31% had inpatient care, and 15% had presented to the emergency department on an annual basis.
This analysis did not address the potential cost and utilization impact of the newer TKIs; improved efficacy and reduced side effects may have a positive impact on overall healthcare utilization and costs in the long-term management of CML, but this remains to be seen.