Economic and medical consequences of myelodysplastic syndromes from a medical perspective

Abstract

17534 Background: The myelodysplastic syndromes (MDS) are a heterogeneous group of bone marrow failure diseases affecting the elderly. The economic impact on Medicare of MDS is largely unknown. A retrospective analysis of total healthcare resource use and cost of MDS patients (pts) was conducted. Methods: The Medicare Standard Analytic File 5% (SAF5%) claims database was used to identify pts with a new primary MDS diagnosis code in first quarter (Jan-Mar) 2003 then followed through Dec 2005. Pts with myeloid leukemia or anemias of known causes in the previous year were excluded. Newly diagnosed MDS pts were descriptively characterized based on potential cause of MDS, MDS-related complications, and MDS therapies. Total healthcare costs and resource utilization for MDS pts were analyzed. Results: Of the 1,713,502 pts in SAF5%, 705 (4 per 10,000) developed MDS in first quarter 2003, including those with a previous history of unexplained anemia 159, (23%), chemotherapy or radiotherapy exposure 43, (6%), and de novo 503 (71%). Mean age was 76 (range 29- 98); 49% male, 90% Caucasian. 2003 median Medicare payment for MDS pts was $17,556, compared to $1,459 for the total SAF5% Medicare population (mean: $28,023.67 vs. $6,739.48; p< 0.001). Median Medicare payments for therapy induced were $34,271, prior anemia $17,191, and de novo MDS $16,493. 278 (39%) died; including 63% of the therapy-induced, 40% of the prior anemia and 37% of the de novo. 79% were hospitalized and 59% had at least one emergency room visit. Of 46% receiving blood transfusions 6% were coded with transfusional hemachromatosis. 314 (45%) received growth factor treatments and 108 (15%) chemotherapy. Of those at risk for MDS-related complications, 55%, 23%, and 2% experienced new onset cardiac complications, diabetes, and hepatic diseases, post MDS diagnosis. Additionally, 51% had pulmonary problems and 45% infections in the 3 year study. Conclusions: The majority of newly diagnosed MDS pts develop disease-related complications, resulting in significantly higher healthcare resource utilization and costs compared to non-MDS patients. No significant financial relationships to disclose.