PCN48 NON-ADHERENCE TO IMATINIB IN CHRONIC MYELOID LEUKEMIA (CML) PATIENTS IS ASSOCIATED WITH SHORT- AND LONG-TERM NEGATIVE IMPACTS ON HEALTH CARE RESOURCE UTILIZATION AND COSTS

Background: Cardiovascular (CV) disease is the leading cause of mortality in both men and women in the US, resulting in substantial health care utilization and costs. There are limited data quantifying long-term resource utilization following an ACS event. Objectives: Evaluate overall and CV-related health care utilization following an ACS event in patients with/without recurrent CV events (CVEs) post-discharge. Methods: Patients with ≥1 ICD-9 CM code for acute myocardial infarction MI) (410.xx) or unstable angina (411.1x) during ACS hospitalization were identified from the HealthCore Integrated Research Database 01/01/2006-09/30/2011. Index date was defined as the first ACS event. Patients with <12 months’ pre-/post-index plan eligibility or age <18 years were excluded. Recurrent CVEs were defined as any occurrence of MI, non-fatal stroke or coronary heart disease-related mortality after the index ACS event. Overall and CV-related health care resource utilization following the index ACS event were evaluated in patients with/without recurrent CVEs. Results: Of 140,903 patients, 22.0% had ≥1 subsequent CVE during follow-up. Patients with/without recurrent CVEs were older (mean 72.4 vs. 65.2 years) and had more comorbidities (mean baseline Deyo-Charlson Index scores 2.4 vs. 1.6). Mean (median) follow up was 2.0 (1.6) and 1.9 (1.5) years in patients with/without recurrent CVEs, respectively. Mean (median) number of 1-year post-index overall and CV-related hospitalizations in the recurrent CVE cohort was higher than the non-recurrent cohort (2.81 [1.98] and 2.40 [1.54] vs. 1.56 [1.23] and 1.30 [0.82], respectively). Mean number of 1-year post-index overall outpatient and office visits were higher in the recurrent versus non-recurrent cohort (31.82 [36.63] and 14.72 [11.15] vs. 21.65 [25.68] and 11.89 [9.67]). Mean annual 3-year utilization post-index showed the same trend (Table). Conclusion: Patients with recurrent CVEs had higher 1- and 3-year post-index overall and CV-related utilization as compared with patients without recurrent CVEs. More aggressive strategies to manage this increased long-term utilization is warranted. This study underscores the need to prevent subsequent adverse CVEs, ultimately to improve patient outcomes and help reduce overall health care utilization.

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Health Care Resource Utilization and Cost in Patients with Chronic Myeloid Leukemia in a Privately Insured Patient Population in the United States,

Blood ◽

10.1182/blood.v118.21.4220.4220 ◽

2011 ◽

Vol 118 (21) ◽

pp. 4220-4220

Author(s):

Shrividya Iyer ◽

Peter C Trask ◽

Gordon Siu ◽

Jack Mardekian

Keyword(s):

Health Care ◽

Chronic Myeloid Leukemia ◽

Resource Utilization ◽

Health Care Costs ◽

Myeloid Leukemia ◽

Index Date ◽

Health Care Resource ◽

Drug Costs ◽

Prescription Drug Costs ◽

Care Costs

Abstract Abstract 4220 Objective: To estimate health care resource use and related costs in patients with chronic myeloid leukemia (CML). Methods: A retrospective cohort analysis was conducted using the Thomson Reuters MarketScan Commercial Claims and Encounters and Medicare Supplemental databases, which is composed of medical and pharmacy claims for approximately 43 million beneficiaries. Cases with at least 2 medical claims associated with a diagnosis of CML (ICD-9-CM code: 205.1) between Jan 1, 2002 and Dec 31, 2009 were extracted from the database. Index date was defined as the date of the first diagnosis of CML. A minimum of six months pre-index and 12 months post index enrollment was required. Disease and non-disease related utilization and costs were estimated. Resource utilization was calculated from index date to last available claims data point and then annualized per patient. Results: A total of 2583 patients were identified with an average follow up of 2.7 years. The mean age of the cohort was 59 years, and 45% were female. Proportions of patients having at least one inpatient, outpatient, and ER CML related visit were found to be 32.4%, 94.9%, and 15.1%, respectively. The average number of visits (standard deviation [SD]) per patient year was found to be 1.3 (1.4) and 1.6 (2.4) for inpatient and ER visits, respectively, among patients who had at least one visit. Average number (SD) of outpatient and office visits per patient year was found to be 40.6 (34.5) and 15.3 (11.6), respectively. Average number of prescriptions filled for CML was 3.3 per patient year. Disease-related health care costs ($23,166) constituted 36% of the total health care costs ($64,441) per patient year. Inpatient ($24,462 ± 77,429), outpatient ($24,391 ± 48,439), and prescription drug costs ($15,588 ± 18,327) accounted for 38%, 38%, and 24% of the total health care costs, respectively. CML drug costs accounted for 73% of the prescription drug costs. Conclusion: Cost burden of chronic myeloid leukemia are substantial. Effective disease management could help reduce resource utilization and cost while improving overall disease outcomes. Disclosures: Iyer: Pfizer: Employment. Trask:Pfizer Inc (at time of work completion): Employment; Sanofi: Employment. Mardekian:Pfizer Inc: Employment, Equity Ownership.

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