Examining Healthcare Resource Utilization (HCRU) and Costs in US Patients Diagnosed with Relapsed Acute Myeloid Leukemia (AML)

Context AML is the most common form of acute leukemia in adults. The age-adjusted incidence of AML in the USA is 4.3/100,000 people, with median age of 68 years at diagnosis. Following diagnosis, treatment options include intensive induction chemotherapy to induce remission (followed by post-remission therapies, including high-dose cytarabine-based regimens and hematopoietic stem cell transplantation), less intensive induction treatment, or supportive care. Prognosis following relapse is poor, with median survival of 8–10 months; studies show much of this time is spent in inpatient or outpatient settings. Objective To examine HCRU, particularly inpatient hospitalizations and associated costs, in relapsed AML patients. Design A retrospective analysis was conducted using the Premier Healthcare Database, a hospital administrative database containing >1 billion inpatient and outpatient encounters in the USA. ICD-10-CM codes for AML in relapse-identified adult patients enrolled in the database between January 1, 2016 and March 31, 2019. The index date was the first relapse encounter date. Patients Patients were followed until inpatient death, or last inpatient discharge date/hospital-based outpatient visit, before the end of study period (September 30, 2019). Main outcome measures Demographics, comorbidities, inpatient and intensive care unit (ICU) admissions, length of stay (LOS), and costs. Results 2,290 patients were identified; mean age was 61.2 years (median 65.0) and 46.9% were female. Primary insurance coverage was Medicare (51.2%), commercial (29.1%), Medicaid (13.8%), or other (5.9%). Common comorbidities were diabetes (31.0%), chronic heart failure (19.5%), and chronic obstructive pulmonary disease (19.0%). Patient follow-up varied from Conclusions The results demonstrate the substantial HCRU burden and costs shouldered by patients and payers following diagnosis of relapsed AML. Though not assessed here, there is potential value in therapies that delay relapse and improve survival in AML patients. The study was supported by Bristol-Myers Squibb.