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Dissecting the Treatment Costs of Newly Diagnosed Myeloma in First 2 Years

February 2015 Vol 8, Special Issue: Payers' Perspectives in Oncology - Multiple Myeloma

San Francisco, CA—In the treatment of patients newly diagnosed with multiple myeloma, medical, nondrug costs, particularly outpatient costs, account for approximately 75% of the total expenditures for the first 2 years after diagnosis, according to a new analysis of a large US claims database presented at ASH 2014.

Recent studies have suggested that medical costs, such as hospital admissions, are the main contributors to overall cost during first-line treatment of patients with relapsed or refractory myeloma using novel agents, said X. Henry Hu of Global Health and Patient Outcomes Research, a division of Celgene Corporation.

“We need to understand the full range of costs associated with the management of myeloma patients,” said Mr Hu.
Mr Hu and colleagues examined the MarketScan database of 6238 patients with newly diagnosed myeloma to analyze the healthcare expenditures for inpatient care, outpatient services, and prescription drugs. Overall, the total healthcare expenditures were $65,607 per patient annually for the first 2 years after diagnosis.

The smallest proportion of costs was attributed to drugs compared with outpatient and inpatient costs during that period. When analyzed by transplantation status, the total annual costs were $182,061 per patient undergoing stem-cell transplant versus $50,840 for other patients (Table).


Table

“Outpatient costs accounted for the greatest proportion of overall costs for both patient groups,” he said.

The distribution of total costs during the first 2 years after diagnosis was fairly similar for the transplant and nontransplant groups.

Overall, the healthcare costs decreased for both patient groups during the second year. The decreases were seen in inpatient and outpatient costs; however, drug costs increased in both groups.

“Changes were most marked in the stem-cell transplant patients,” Mr Hu noted. “Transplant costs were considerably higher during the first year following diagnosis than in the subsequent year.”

In year 2, the transplant group had 63% lower inpatient costs and 50% lower outpatient costs, but the drug costs increased by 28%. For the nontransplant group, the inpatient costs were 46% lower, the outpatient costs were 29% lower, and the drug costs were increased by only 4% in year 2 versus in year 1 after the diagnosis.

The investigators concluded that outpatient costs account for most expenditures, and that stem-cell transplant is associated with markedly higher healthcare expenditures, particularly with respect to inpatient costs, particularly in year 1.—KS

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Last modified: August 30, 2021