Healthcare resource utilization and costs associated with acute graft-versus-host disease following allogeneic hematopoi
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ORIGINAL ARTICLE
Healthcare resource utilization and costs associated with acute graft-versus-host disease following allogeneic hematopoietic cell transplantation Jingbo Yu 1 & Lincy Lal 2 & Amy Anderson 2 & Mary DuCharme 2 & Shreekant Parasuraman 1 & Daniel Weisdorf 3 Received: 9 August 2019 / Accepted: 26 February 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose The contribution of acute graft-versus-host disease (GVHD) to healthcare resource utilization (HCRU) and costs following allogeneic hematopoietic cell transplantation (HCT) has not been extensively investigated. The objective of this study was to estimate both inpatient and outpatient HCRU and costs associated with acute GVHD during the 100-day and 1-year periods after allogeneic HCT in the USA. Methods A retrospective analysis of administrative claims from the Optum® Research Database of patients aged ≥ 12 years who received HCT between 2010 and 2016 was conducted. Costs and HCRU among patients with acute GVHD and no GVHD were compared during the 100-day (acute GVHD, n = 723; no GVHD, n = 385) and 360-day (acute GVHD, n = 445; no GVHD, n = 227) periods after HCT. Results Patients with acute GVHD had significantly more (P < 0.001) mean office visits (47 vs 32), hospital outpatient visits (71 vs 35), and inpatient stays (2.8 vs 1.1) than patients with no GVHD during 360 days post-HCT; similar findings were observed over the 100-day period. Mean total all-cause costs were significantly higher (P < 0.001) for patients with acute GVHD versus no GVHD during both post-HCT periods (100-day, $316,458 vs $215,229; 360-day, $466,720 vs $263,568). Additional factors associated with increased 360-day costs included young age (12–17 years; P < 0.001) and peripheral blood as graft source (P = 0.03). Conclusion Acute GVHD was associated with significant HCRU and costs in the first 100 days of transplant, increasing over the first year post-HCT. Inpatient care was the primary driver, but outpatient care and related costs were also increased. Keywords Acute graft-versus-host disease . Allogeneic hematopoietic cell transplantation . Inpatient healthcare resource utilization . Total costs
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00520-020-05382-4) contains supplementary material, which is available to authorized users. * Jingbo Yu [email protected] 1
US Medical Affairs, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, DE 19803, USA
2
Optum, Inc., 11000 Optum Circle, Eden Prairie, MN 55344, USA
3
University of Minnesota, 516 Delaware St SE, Minneapolis, MN 55455, USA
Advanced hematologic malignancies, marrow failure states, and certain nonmalignant diseases can be treated with allogeneic hematopoietic cell transplantation (HCT) [1, 2]. Consequently, HCT has become more widely used as a treatment for many diseases in recent decades [3]. In the USA alone, more than 8000 allogeneic transplants are performed each year, and the number has been increasing in recent ye
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