Healthcare Utilization, Costs High for Transplant for Hematology Malignancies

Patients with hematology malignancies that require hematopoietic stem cell transplantation (HCT) had considerable cancer-related health care utilization and costs, according to a recent study.


For commercially insured patients the mean-adjusted incremental cancer-related costs were $399,011 including pre-diagnostic and pre-HCT periods. For patients with Medicare supplemental insurance, the cost was $195,575 for the same period.


The study included 2,663 commercially insured patients and 266 Medicare patients from the IBM MarketScan Research Databases. All patients were 18 or older and had undergone HCT for hematologic malignancies from January 2008 to December 2017.


In-patient care accounted for about half of the cost for both patient groups. Among commercially insured patients, approximately 9% of costs were in the pre-diagnostic period and the remainder occurred in pre-HCT follow-up.


Costs varied by the type of hematologic malignancies. The costs were highest for acute lymphocytic leukemia followed by non-Hodgkin lymphoma, acute myeloid leukemia, myelodysplastic syndromes, and myeloproliferative disorders.


“Notably, the cost of treatment per month until HCT was approximately $40,000 for the entire study population and was highest for ALL and AML, approximately $57,000 and $49,000 per month respectively, and lowest for NHL, MDS and MPN ($21,000, $19,000, and $15,000

per month, respectively),” the researchers wrote.


“This analysis demonstrates that the cancer-related resources incurred from the time patients develop their hematologic malignancy to the time of the HCT are substantially and significantly higher than baseline costs for patients who progress to HCT,” the researchers wrote.