scholarly journals Cost-analysis of Treatment of Patients with Acute Myeloid Leukemia

2021 ◽  
Vol 14 (8) ◽  
Author(s):  
Vahid Alipour ◽  
Soroush Rad ◽  
Fateme Mezginejad ◽  
Reza Jahangiri ◽  
Rafat Bagherzadeh ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Cost Analysis ◽  
Myeloid Leukemia ◽  
Descriptive Analysis ◽  
Medical Costs ◽  
Nonparametric Tests ◽  
Nursing Visit ◽  
Payer Perspective ◽  
The Cost ◽  
Acute Myeloid

Background: Acute myeloid leukemia (AML) is the second common leukemia (5.18%) and the third deadliest leukemia in Iran. Moreover, it is the fifth prevalent cancer in the world, which involves 8% of all cancers. Objectives: The aim of this study was to calculate direct medical and non-medical costs of AML in 2019. Methods: The present retrospective-descriptive analysis was conducted on 192 patients with AML aged 19 to 70 years from 2016 to 2018. The data were collected from hospital records and interviews with experts. The bottom-up micro-costing approach and payer perspective was considered for cost analysis status. The relationship of affective variables was investigated, using nonparametric tests, including Mann–Whitney and Kruskal–Wallis tests. Costs were divided into costs of diagnosis, hospitalization, medication, nursing, visit and consultation, operating room, and medical supplies. The data were described by mean ± standard deviation and reported by percentage and also analyzed by SPSS 11 software. Results: According to the findings, the average age of all patients was 43.91 years and 55.7% of the patients were male. The highest and the lowest diagnostic costs were associated with laboratory tests at $1656459.48 and ultrasound charges $4229.46, respectively. The total direct medical costs per patient were $1056624.78 with an average of $4846.90 and the cost of medication included 36% of the total costs. The direct medical and non-medical costs were $10485488.48 and $487522.87, respectively Conclusions: Costs of AML treatment were estimated to be $1056624.78. Finally, it can be concluded that the cost of AML in Iran is much cheaper than that compared to other countries and also due to hidden subsidies from the public sector, the payment from the patient's pocket is very small.

scholarly journals Medical costs of treatment and survival of patients with acute myeloid leukemia in Belgium

2016 ◽  
Vol 46 ◽  
pp. 26-29 ◽  
Author(s):  
A.L. Van de Velde ◽  
P. Beutels ◽  
E.L. Smits ◽  
V.F. Van Tendeloo ◽  
G. Nijs ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Medical Costs ◽  
Costs Of Treatment ◽  
Acute Myeloid

scholarly journals Long-Term Medical Costs and Life Expectancy of Acute Myeloid Leukemia: A Probabilistic Decision Model

2014 ◽  
Vol 17 (2) ◽  
pp. 205-214 ◽  
Author(s):  
Han-I Wang ◽  
Eline Aas ◽  
Debra Howell ◽  
Eve Roman ◽  
Russell Patmore ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Life Expectancy ◽  
Myeloid Leukemia ◽  
Decision Model ◽  
Medical Costs ◽  
Acute Myeloid

Acute Myeloid Leukemia: Challenges and Real World Data from India

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 3685-3685
Author(s):  
Chepsy C Philip ◽  
Biju Geoge ◽  
Abhijeet Ganapule ◽  
Kavitha M Lakshmi ◽  
Fouzia N Abubacker ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Fungal Infection ◽  
Induction Chemotherapy ◽  
Myeloid Leukemia ◽  
Standard Of Care ◽  
Newly Diagnosed ◽  
Duration Of Symptoms ◽  
Npm1 Mutation ◽  
The Cost ◽  
Acute Myeloid

Abstract Management of acute myeloid leukemia (AML) in India remains a challenge. With a human development index rank of 134, a per capita gross net income of US$3500 and a government expenditure of only 1.2% of GDP allocated for health (http://indiabudget.nic.in) a major constraint to treatment of AML remains the cost of therapy. In the majority (>80%), in the absence of a universal and comprehensive health insurance, most payments are out of pocket (Karan et al. Health Policy and Planning 2008). We undertook a two year prospective study to evaluate the clinical characteristics and outcome of patients with a diagnosis of AML (AML-M3 excluded) referred to our tertiary care center. The study was conducted from July 2012 till June 2014 and was approved by the institutional ethics committee. In addition to standard of care diagnostic tests and therapy a detailed questionnaire was administered to patients at diagnosis and on follow up. A total of 427 patients were diagnosed with AML during this period. Of these 380 (89%) were newly diagnosed. Of the newly diagnosed 47 (12.3%) were ≤ 15 years and 62 (16.3%) were ≥ 60 years old. The age distribution of newly diagnosed cases is illustrated in Figure 1A. The median age of newly diagnosed patients was 40 years (range: 1-79) and there were 244 (64.2%) males. The median duration of symptoms prior to first presentation at our hospital was 4 weeks (range: 1-52). ECOG performance score at presentation was ≤ 2 in 94.7%. Cytogenetic data was available in 281 and of these 33 (11.7%), 197 (70.1%) and 51 (18.2%) were in the good, intermediate and adverse risk groups respectively. FLT3 and NPM1 mutation status was available in 143 and of these 22 (15.8%) and 5 (3.4%) were FLT3-/NPM+ and FLT3+/NPM- respectively. The median distance from home to hospital was 580km (range: 6-3200) and 27 patients were from another country. 348 (91.6%) patients were self paying with all expenses being out of pocket (data was not available in 7). Of the newly diagnosed patients only 109 (28.7%) opted for standard of care and were admitted for induction chemotherapy (Figure 1B). The comparison of the 109 that took treatment and the 271 (71.3%) that did not revealed that these two groups were comparable for the above baseline characteristics with the following exceptions; those that did not take treatment resided significantly further away from the hospital, had significantly longer duration of symptoms prior to reaching our hospital and were significantly less likely to be ≤15 years. Of the 271 that did not take treatment the major reason was lack of financial support in 219 (80.8%), lack of social support in 46 (17.6%) and a combination of denial, choice of alternative medicines, apathy and fatalistic attitude in 39 (14.9%). 220 (81%) of those that did not receive treatment were ≤ 60 years old. Induction chemotherapy consisted of standard induction as in the BFM98 protocol for patients ≤15 years, conventional 7/3 in adults and hypomethylating agents in older patients or in young adults with significant co morbidities at the discretion of the treating physician (n=12(11%) and of these 6 were ≥60 years). Following induction chemotherapy 100% developed febrile neutropenia. Blood cultures detected an organism in 71 (65%) on at least one occasion and the organism was a Gram negative bacilli (GNB) in 45 (42%), Gram positive in 18 (16%) and mixed/ alternate infection in 8 (7%). Of the GNB 19 (42%) were carbapenem resistance organisms (CRO) (Figure 1C). 30 (27.5%) had a fungal infection in induction which was proven (EORTC/MSG criteria) in 4 (Figure 1D). There were 27 (24.7%) inductions deaths and of these 18 (67%) were due to sepsis related to GNB of which in 12(67%) the organism was a CRO. Among the patients that had an induction death in 12 (52%) there was evidence of a fungal infection which was proven in one case. The overall survival at one year was 70.4%±10.7%, 55.6%±6.8% and 42.4%±15.6% in patients ≤ 15 years, >15to <60 years and in ≥ 60 years age groups respectively. In conclusion there are significant challenges in the management of AML in India. The major reason for not proceeding with treatment is the absence of financial resources. Induction deaths are related to a high incidence of multi-drug resistant organisms and fungal infections. The biggest constraint is the cost of the treatment and the absence of a health security net to treat all patients with this diagnosis. Disclosures Srivastava: Octapharma: Consultancy, Other.

The Economic Burden of Acute Myeloid Leukemia in Iran

2021 ◽  
Author(s):  
Vahid Alipour ◽  
Soroush Rad ◽  
Fateme Mezginejad ◽  
Zeinab Dolatshahi ◽  
Reza Jahangiri ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Economic Burden ◽  
Myeloid Leukemia ◽  
Indirect Costs ◽  
Direct Costs ◽  
Great Opportunity ◽  
The Third ◽  
Productivity Losses ◽  
The Cost ◽  
Acute Myeloid

Abstract BackgroundCancer imposes a significant economic burden on the health system and society. Acute myeloid leukemia (AML) is the third deadliest leukemia and is one of the leading health problems worldwide. The present study aims to estimate the economic burden of AML in Iran for 2020.MethodsIn this study, we estimated a prevalence-based on the cost-of-illness of the AML in Iran. A societal perspective was considered, in which the direct costs and productivity losses with the adoption of the human capital approach in the AML cases were estimated for 2020. Moreover, in the present study, several resources including national cancer registry reports, hospital records, occupational data, and interviews with experts were cited.ResultApproximately 98% of patients with AML received induction therapy. The AML economic burden was $ 33243107.39. Indirect costs accounted for 60% of this amount, and direct medical costs made up for 19% of this estimated economic burden.ConclusionThe economic burden of AML in Iran is very significant and due to the increasing prevalence of this disease, it is expected to increase more gradually. Awareness of the costs associated with this disease provides a great opportunity for policymakers and managers of the health systems to improve resource allocation efficiently.

scholarly journals Daunorubicin and Cytarabine (Vyxeos)

2021 ◽  
Vol 1 (8) ◽  
Author(s):  
Reimbursement Team
Keyword(s):  
Acute Myeloid Leukemia ◽  
Acute Leukemia ◽  
Myeloid Leukemia ◽  
Adult Patients ◽  
Inpatient Setting ◽  
Intensive Chemotherapy ◽  
Newly Diagnosed ◽  
The Cost ◽  
Public Drug ◽  
Acute Myeloid

CADTH recommends that Vyxeos should be reimbursed by public drug plans for the treatment of adults with newly diagnosed therapy-related acute myeloid leukemia (t-AML) or AML with myelodysplasia-related changes (AML-MRC) if certain conditions are met. Vyxeos should only be reimbursed if the induction cycles are administered in an inpatient setting and supervised by a hematologist with expertise in managing patients with acute leukemia and if the cost of Vyxeos is reduced. Vyxeos should only be covered to treat adult patients with newly diagnosed t-AML or AML-MRC who were deemed fit for intensive chemotherapy by the treating physician.

Real-World Costs of Azacitidine Treatment in Patients With Higher-Risk Myelodysplastic Syndromes/Low Blast–Count Acute Myeloid Leukemia

2020 ◽  
pp. OP.20.00446
Author(s):  
Lee Mozessohn ◽  
Matthew C. Cheung ◽  
Nicole Mittmann ◽  
Craig C. Earle ◽  
Ning Liu ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Quantile Regression ◽  
Real World ◽  
Myeloid Leukemia ◽  
World Health ◽  
Administrative Databases ◽  
The Real ◽  
Blast Count ◽  
The Cost ◽  
Acute Myeloid

PURPOSE: Azacitidine (AZA) is a standard of care for higher-risk myelodysplastic syndrome (MDS)/low blast–count acute myeloid leukemia (AML). Despite this, there is a paucity of data on the real-world health care resource utilization costs of AZA in this population. METHODS: We linked the Ontario AZA MDS registry—higher-risk MDS/low blast–count AML—to population-based health system administrative databases. Patients were observed for 24 months after first AZA and censored at the earliest of 90 days after last AZA, date of death, time of AML induction/stem-cell transplantation, or March 31, 2016. Costs (2015 Canadian dollars) were expressed as standardized mean and median 28-day costs. Univariable quantile regression was used to explore the association of baseline patient and disease characteristics and median cost. Multivariable quantile regression was used to explore predictors of median costs. RESULTS: Among 877 patients in the registry, mean standardized 28-day cost per patient was $17,638 (median, $15,272; interquartile range [IQR], $11,869-$19,580) and $13,450 (median, $11,043; IQR, $7,981-$14,882) excluding the cost of AZA. Major nondrug drivers of cost were cancer clinic visits and inpatient care (mean standardized 28-day cost, $4,631; median, $1,558; IQR, $238-$4,961). Transfusion dependence at AZA initiation ( P = .001) and greater comorbid disease burden ( P = .009) were independently associated with increased cost. CONCLUSION: Our cohort of patients with uniformly higher-risk MDS/low blast–count AML treated with AZA demonstrates substantial costs of care above and beyond the cost of AZA alone. These results provide insight into the costs of AZA in the real world with implications for resource allocation.

scholarly journals Cost-effectiveness of azacitidine and venetoclax in unfit patients with previously untreated acute myeloid leukemia

2021 ◽  
Vol 5 (4) ◽  
pp. 994-1002
Author(s):  
Kishan K. Patel ◽  
Amer M. Zeidan ◽  
Rory M. Shallis ◽  
Thomas Prebet ◽  
Nikolai Podoltsev ◽  
...  
Keyword(s):  
Overall Survival ◽  
Acute Myeloid Leukemia ◽  
Cost Effectiveness ◽  
Incremental Cost ◽  
Myeloid Leukemia ◽  
Cost Effective ◽  
Life Years ◽  
Unfit Patients ◽  
The Cost ◽  
Acute Myeloid

Abstract The phase 3 VIALE-A trial reported that venetoclax in combination with azacitidine significantly improved response rates and overall survival compared with azacitidine alone in older, unfit patients with previously untreated acute myeloid leukemia (AML). However, the cost-effectiveness of azacitidine-venetoclax in this clinical setting is unknown. In this study, we constructed a partitioned survival model to compare the cost and effectiveness of azacitidine-venetoclax with azacitidine alone in previously untreated AML. Event-free and overall survival curves for each treatment strategy were derived from the VIALE-A trial using parametric survival modeling. We calculated the incremental cost-effectiveness ratio (ICER) of azacitidine-venetoclax from a US-payer perspective. Azacitidine-venetoclax was associated with an improvement of 0.61 quality-adjusted life-years (QALYs) compared with azacitidine alone. However, the combination led to significantly higher lifetime health care costs (incremental cost, $159 595), resulting in an ICER of $260 343 per QALY gained. The price of venetoclax would need to decrease by 60% for azacitidine-venetoclax to be cost-effective at a willingness-to-pay threshold of $150 000 per QALY. These data suggest that use of azacitidine-venetoclax for previously untreated AML patients who are ineligible for intensive chemotherapy is unlikely to be cost-effective under current pricing. Significant price reduction of venetoclax would be required to reduce the ICER to a more widely acceptable value.

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