Medical complications, resource utilization and costs in patients with myelofibrosis by frequency of blood transfusion and iron chelation therapy

Leuk Lymphoma. 2015;56(10):2803-11. doi: 10.3109/10428194.2015.1016933. Epub 2015 Mar 30.

Abstract

Iron chelation therapies (ICTs) can help eliminate iron surplus in erythrocyte transfusion-dependent (TD) patients with myelofibrosis (MF). The study assessed adjusted incidence rate ratios (aIRRs) of MF-related complications and resource utilization (RU) and adjusted mean monthly inpatient cost differences in patients with TD MF treated with versus without ICT (ICT+ vs. ICT-) using data from two healthcare claims databases. Patients with ≥ 2 MF International Classification of Diseases, 9th Revision (ICD-9) diagnosis codes ≥ 30 days apart were included. Among 571 patients with TD MF, 103 (18%) were ICT+ and 468 (82%) were ICT-. ICT+ patients had lower rates of thrombocytopenia (aIRR: 0.55; p < 0.001), pancytopenia (0.53; p < 0.001), emergency room visits (0.84 [95% confidence interval: 0.74-0.96]) and inpatient stays (0.75 [0.64-0.87]), but higher rates of outpatient visits (1.21 [1.18-1.23]). Adjusted mean complication-related inpatient cost difference per month was lower in ICT+ patients (-$1804 [$570]; p = 0.004). ICT+ patients had significantly lower rates of acute care, but higher rates of outpatient care.

Keywords: Myelofibrosis; economic cost; iron chelation therapy; medical resource utilization; transfusion dependent.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Transfusion* / economics
  • Chelation Therapy* / economics
  • Databases, Factual
  • Erythrocyte Transfusion / adverse effects
  • Erythrocyte Transfusion / economics
  • Female
  • Health Care Costs*
  • Health Resources* / economics
  • Humans
  • Incidence
  • Insurance, Health
  • Iron Chelating Agents* / economics
  • Iron Chelating Agents* / therapeutic use
  • Male
  • Middle Aged
  • Prevalence
  • Primary Myelofibrosis / complications*
  • Primary Myelofibrosis / epidemiology*
  • Primary Myelofibrosis / therapy
  • Retrospective Studies
  • Transfusion Reaction
  • United States / epidemiology
  • Young Adult

Substances

  • Iron Chelating Agents