February 2014 Vol 7, No 1, Special Issue ASH 2013 Payers' Perspectives in Oncology - Health Economics
Wayne Kuznar

New Orleans, LA—Peripheral T-cell lymphoma (PTCL) is associated with high resource utilization rates and high overall costs, according to a multicenter study presented at ASH 2013. Hospitalizations, in particular, represent a major clinical and economic burden, indicating the need for treatments requiring lower resource utilization with better PTCL management.

Michele H. Potashman, PhD, of Millennium Pharmaceuticals, Cambridge, MA, and colleagues, studied 1000 patients with PTCL identified by International Classification of Diseases, Ninth Revision (ICD-9) codes over a period from October 1, 2007, to June 30, 2011. Truven Health Analytics MarketScan data for commercially insured and Medicare supplemental patients were used to retrospectively identify patients with PTCL. This database comprises medical and pharmaceutical claims for more than 100 million unique patients across the United States.

To be included in the study, patients had to have at least 6 months of continuous enrollment before their index date and 12 months of continuous enrollment after their index date.

The mean patient age was 56 years, 58% of the patients were male, and all patients had a high rate of comorbidities (mean Charlson Comorbidity Index of 1.72 vs 0.39 for the control group).

The control group included 5000 randomly selected patients without PTCL, and was considered to represent the average insured patient population.

Monthly healthcare costs were measured and annualized to provide average annual costs. Healthcare costs included hospitalizations; pharmacy services; office visits; emergency department visits; hospice stays; stem-cell transplant; and other patient-related costs, such as laboratory procedures, blood transfusions, and radiology procedures.

The cost estimates were based on net payments received by the providers, and healthcare costs included hospitalizations, pharmacy services, office visits, emergency department visits, and hospice stays.

High Annual Costs
“On an average annual basis, PTCL patients were hospitalized more often and experienced a longer length of stay compared with matched controls,” noted Dr Potashman. “In addition, PTCL patients had higher utilization of office visits, pharmacy services, emergency room visits, and hospice care.”

Overall, the average annual costs were $75,934.08 for patients with PTCL compared with $4660.64 for the matched controls, driven mainly by hospitalizations (32.2% of overall costs) and pharmacy services (19.6% of overall costs).

A total of 50% of the patients with PTCL compared with 13.8% of the controls had hospitalizations. Emergency department visits were almost twice as frequent in patients with PTCL as in the control group—47% versus 25%, respectively.

The mean cost of hospitalization per patient was $24,427 for the patients with PTCL versus $1058 for the controls (P <.001).

Some 11.4% of patients with PTCL had stem-cell transplant compared with none of the controls. The mean cost per patient undergoing transplant in the PTCL cohort for a first stem-cell transplant was $126,093.58.

The most common diagnoses associated with hospitalization (based on ICD-9 codes) among the patients with PTCL were fever, fatigue, dizziness, dyspnea, chest pain, cough, and other chest symptoms.

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Last modified: March 4, 2014
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