Healthcare resource utilization and costs during first salvage therapy for relapsed or refractory acute myeloid leukemia in the United States

Leuk Lymphoma. 2023 Nov-Dec;64(11):1832-1839. doi: 10.1080/10428194.2023.2235044. Epub 2023 Jul 24.

Abstract

Real-world US healthcare resource utilization (HRU) and costs during first salvage therapy for relapsed/refractory (R/R) acute myeloid leukemia (AML) are described using IBM MarketScan® data (1/1/2007-6/30/2020). Treatments included high- (HIC) and low-intensity chemotherapy (LIC) alone, and gilteritinib, other FLT3 tyrosine kinase inhibitors (TKIs), and venetoclax with or without chemotherapy. Patients were diagnosed with R/R AML at ≥18 years of age between 1/1/2017-12/31/2019. Patient monthly all-cause HRU and costs were analyzed using a fixed-effects model. Data from 399 patients were analyzed (HIC, n = 104; LIC, n = 133; gilteritinib, n = 14; other FLT3 TKIs, n = 68; venetoclax, n = 80). Inpatient HRU was generally highest with HIC, whereas outpatient HRU was generally highest with LIC and venetoclax. Total all-cause incremental monthly costs appeared to be highest with HIC ($171,982) and similar for LIC ($60,512), gilteritinib ($47,218), other FLT3 TKIs ($43,218), and venetoclax ($77,566). Results highlight HRU and cost differences for R/R AML during first salvage therapy.

Keywords: Chemotherapy; acute myeloid leukemia; gilteritinib; healthcare economics; relapsed/refractory AML; tyrosine kinase inhibitors (midostaurin and sorafenib).

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Humans
  • Leukemia, Myeloid, Acute* / drug therapy
  • Mutation
  • Patient Acceptance of Health Care
  • Salvage Therapy*
  • United States / epidemiology
  • fms-Like Tyrosine Kinase 3

Substances

  • gilteritinib
  • venetoclax
  • fms-Like Tyrosine Kinase 3