PCN350 USING REAL WORLD DATA TO DETERMINE HEALTH SYSTEM COSTS OF CANADIANS DIAGNOSED WITH CHRONIC LYMPHOCYTIC LEUKEMIA

Abstract

With the recent advances of novel treatments for patients with chronic lymphocytic leukemia (CLL), and fiscal constraints of the publicly funded healthcare system in Canada, understanding the real world economic impact of CLL is critical. The objective of this study was to determine the health system costs of CLL patients treated in Ontario, Canada. Patients diagnosed and treated between January 1, 2010 and December 31, 2017 were identified in the Ontario Cancer Registry and linked to provincial administrative databases, capturing hospitalizations, cancer clinic visits, physician services and novel treatments (radiation and inexpensive chemotherapies were excluded). Total cohort, annual and mean per patient/control costs (CAD 2017) were determined using a costing methodology available at the Institute for Clinical Evaluative Sciences called GETCOST. Short-term episodes (e.g., hospitalizations) attributed costs by multiplying the encounter’s resource intensity weight by an annual cost per weighted case; long-term episodes (e.g., complex care) attributed costs by weighted days, and costs of visit-based encounters were determined by utilization. 2,572 CLL patients/cases were identified and matched with 7,611 controls (median age 68 years; 66% male). The overall total cost for cases was $254.7M (mean cost per patient was $99,900); oral medications based on list price ($56.5M), inpatient hospitalizations ($49.1M), and cancer clinic visits ($46.2M) were the top three cost contributors. The mean cost per control was $46,382 with inpatient hospitalizations, physician services and oral medications the top three cost contributors. For CLL patients, year 1 after diagnosis had the highest mean cost ($31,928) followed by year 2 ($17,665). By calendar year, 2016 and 2017 had the highest mean costs. Real world costs for CLL patients may have been increasing over time. Exploring whether investment in new novel agents resulted in improved survival would be key.