AML-117: The Economic Burden of Relapse in Acute Myeloid Leukemia (AML): A Retrospective Analysis of US Commercial and Medicare Claims

Abstract

Context AML is a malignant bone marrow cancer with substantial economic burden and poor prognosis. Remission rates in AML are 40–70% and most patients relapse. AML is associated with high healthcare resource utilization (HCRU), but this burden is understudied. Objective To assess the HCRU and costs associated with AML following relapse. Design A retrospective analysis of the IBM® MarketScan® Commercial and Medicare Supplemental Claims database, from January 1, 2012 to December 31, 2018, identified newly diagnosed AML patients (ICD-10-CM codes: 205.00, C92.00, C92.60, C92.A0) who received frontline therapy and no hematopoietic stem cell transplantation. Patients were continuously enrolled in medical and pharmacy benefits for ≥6 months prior to the AML diagnosis date (index date) and for a variable period post-index date; patients were followed until the earliest date of end of continuous enrollment, death, or end of study. Remission was identified by diagnosis codes and relapse was identified by diagnosis codes and treatment-based proxy. Main outcome measures HCRU and costs were analyzed descriptively. Results Of 1,558 patients identified, median age at diagnosis was 62.0 years and median follow-up was 232 days. Less than half of patients achieved remission (45.6%), of which 37.6% relapsed. Median time to relapse from start of frontline therapy was 168 days. Following relapse, mean total all-cause per patient healthcare cost was $282,360 (SD $417,931). 85.8% of patients had an inpatient admission with a per patient mean of 2.3 admissions and cost of $188,264 (SD $367,441). 47.2% of patients had ER visits with a per patient mean of 1.4 visits and cost of $1,573 (SD $3,603). 93.3% of patients had outpatient hospital services and 76.0% had office visits, with a per patient mean of 192.2 services and 12.5 visits, and costs of $63,291 (SD $107,952) and $1,785 (SD $2,964), respectively. Similar trends were observed for AML-related HCRU and costs. Conclusions This study demonstrates the economic burden associated with AML relapse. This burden is driven by inpatient admissions, which account for 67% of total all-cause cost. There remains an unmet need for novel treatments to delay relapse and reduce healthcare costs in AML patients. The study was supported by Bristol Myers Squibb.