PCN139 A RETROSPECTIVE DATABASE ANALYSIS SHOWS HIGH HEALTHCARE RESOURCE UTILIZATION AND COSTS IN PATIENTS WHO DEVELOP POST-TRANSPLANT LYMPHOPROLIFERATIVE DISEASE WITHIN THE FIRST YEAR AFTER ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANT

Abstract

Post-transplant lymphoproliferative disease (PTLD) is an ultra-rare disease following allogeneic hematopoietic stem cell transplant (HCT) or solid organ transplant. Healthcare resource utilization (HRU) and costs in PTLD patients following allogeneic HCT were evaluated using a large US administrative claims database. MarketScan Commercial and Medicare Supplemental database claims from 07/01/2010-12/31/2017 were analyzed. Patients eligible for analysis received an allogeneic HCT between 01/01/2011-12/31/2015, had ≥6 months of continuous enrollment before the HCT, and had ≥1 claim for PTLD or ≥1 inpatient or ≥2 outpatient claims for lymphoma within 1 year following HCT (first claim was the PTLD index). Patients with any lymphoma diagnosis 6 months before HCT were excluded. All-cause HRU claims and total paid amounts were assessed from the week before the HCT through 1-day pre-PTLD index (HCT to PTLD) and from PTLD index through 1-year post-PTLD index. HRU are reported as means (SD). Overall, 92 patients were eligible for analysis. From HCT to PTLD, 98.9% of patients were hospitalized, with 1.7 (1.2) hospitalizations/patient. Average length of stay was 25.3 (22.2) days/patient. From HCT to PTLD, 98.9% of patients had outpatient services with 233.7 (261.1) services/patient and 91.3% of patients had a prescription fill with 32.9 (26.0) prescriptions/patient. Within the first month of PTLD diagnosis, 51.2% of patients were hospitalized, 100% had an outpatient service, and 85.7% had a prescription. Mean inpatient, outpatient, and pharmacy paid amounts/patient from HCT to PTLD were $329,268, $59,437, and $10,765, respectively, and for 1-year post-PTLD were $230,808, $168,292, and $29,943, for an overall total mean paid amount/patient of $828,513. HRU and costs from HCT to PTLD were high and more than doubled within 1-year post-PTLD, driven by hospitalization and high utilization in the first month following PTLD. Effective treatments are needed to reduce the burden of PTLD.