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Healthcare resource utilization and costs associated with acute graft-versus-host disease following allogeneic hematopoietic cell transplantation

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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.

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Acknowledgments

Writing assistance was provided by Jane Kovalevich, PhD, at Complete Healthcare Communications, LLC (North Wales, PA), a CHC Group company, and was funded by Incyte Corporation.

Funding

The study was funded by Incyte Corporation.

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Authors and Affiliations

  1. US Medical Affairs, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, DE, 19803, USA

    Jingbo Yu & Shreekant Parasuraman

  2. Optum, Inc., 11000 Optum Circle, Eden Prairie, MN, 55344, USA

    Lincy Lal, Amy Anderson & Mary DuCharme

  3. University of Minnesota, 516 Delaware St SE, Minneapolis, MN, 55455, USA

    Daniel Weisdorf

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  1. Jingbo Yu
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  2. Lincy Lal
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  3. Amy Anderson
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  5. Shreekant Parasuraman
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  6. Daniel Weisdorf
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Corresponding author

Correspondence to Jingbo Yu.

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Conflict of interest

JY and SP are employees and shareholders of Incyte Corporation. LL is an employee of Optum, Inc. AA and MD are employees and shareholders of Optum, Inc. (UnitedHealth Group). DW has received research support from Incyte Corporation, and support as a consultant from Pharmacyclics, FATE, and CSL Behring.

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Yu, J., Lal, L., Anderson, A. et al. Healthcare resource utilization and costs associated with acute graft-versus-host disease following allogeneic hematopoietic cell transplantation. Support Care Cancer 28, 5491–5499 (2020). https://doi.org/10.1007/s00520-020-05382-4

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  • DOI: https://doi.org/10.1007/s00520-020-05382-4

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