PCN120 ECONOMIC BURDEN FOR PATIENTS WITH NEWLY DIAGNOSED ACUTE LYMPHOBLASTIC LEUKEMIA (ALL) IN COMPLETE REMISSION (CR)

Abstract

To examine the economic burden of patients with newly diagnosed B-cell ALL in CR using real world data. Patients with ≥1 inpatient or ≥2 outpatient diagnoses (30-days apart) of remission ALL (after first ALL diagnosis) were extracted from MarketScan Commercial and Medicare Supplemental Databases from 4/1/2011-2/28/2018. All patients had ≥1 leukemia related hospitalization after first ALL diagnosis, no medications for T-Cell or Ph+ ALL, no ALL diagnosis or leukemia hospitalization or hematopoietic stem-cell-transplantation or cancer during the 12-month before the first ALL diagnosis. Patients were followed from index date (ALL in remission) until the earliest of relapse, inpatient death, end of continuous enrollment, or end of the study period. Hospitalizations and plan paid costs (in 2018 dollars) were calculated at the patient level and admission level. A total of 1298 patients met the study criteria, including 431 ≥18 years old (mean age: 44.5 years, male: 55.9%, mean days of follow up: 462) and 867 under 18 years (6.9, 55.2%, 733). The majority of patients with ALL in CR had ≥1 hospitalization (adults: 88.2%; pediatrics: 90.4%). Among patients with ≥1 hospitalization, each patient had 5.0 hospitalizations on average (adults: 4.4, pediatrics: 5.3); adults had a longer average length of stay (LOS) per hospitalization (8.2 vs. 4.5 days) and longer total number of days in hospital (36 vs. 24) than pediatrics. The corresponding costs per hospitalization were $53,286 vs. $27,835 and total inpatient costs per patient were $235,020 vs. $147,695, for adults and pediatrics, respectively. Among all patients (including those without any hospitalization), total costs were $381,844 (inpatient: 54.3%, outpatient medical: 35.6%; outpatient pharmacy: 10.1%) for adults and $324,139 (41.2%, 56.3%, 2.5%) for pediatrics. In both adult and pediatric patients newly diagnosed with ALL in CR, the economic burden was substantial, with large number of hospitalizations, extended LOS, and high costs.