title: Medical complications, resource utilization and costs in patients with myelofibrosis by frequency of blood transfusion and iron chelation therapy.
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.
authors: a Groupe d'analyse , Ltée, Montréal , Québec , Canada.
authors: Francis
authors: F
authors: Vekeman
authors: b Analysis Group, Inc ., Boston , MA , USA.
authors: Wendy Y
authors: WY
authors: Cheng
authors: c Novartis Pharmaceuticals Corporation , East Hanover , NJ , USA.
authors: Medha
authors: M
authors: Sasane
authors: b Analysis Group, Inc ., Boston , MA , USA.
authors: Lynn
authors: L
authors: Huynh
authors: b Analysis Group, Inc ., Boston , MA , USA.
authors: Mei Sheng
authors: MS
authors: Duh
authors: c Novartis Pharmaceuticals Corporation , East Hanover , NJ , USA.
authors: Carole
authors: C
authors: Paley
authors: d Mayo Clinic Cancer Center , Scottsdale , AZ , USA.
authors: Ruben A
authors: RA
authors: Mesa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion / Q000191:economics; D015913:Chelation Therapy / Q000191:economics; D016208:Databases, Factual; D017707:Erythrocyte Transfusion / Q000009:adverse effects / Q000191:economics; D005260:Female; D017048:Health Care Costs; D006295:Health Resources / Q000191:economics; D006801:Humans; D015994:Incidence; D007348:Insurance, Health; D007502:Iron Chelating Agents / Q000191:economics / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D055728:Primary Myelofibrosis / Q000150:complications* / Q000453:epidemiology* / Q000628:therapy; D012189:Retrospective Studies; D065227:Transfusion Reaction; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D007502:Iron Chelating Agents
keywords: Myelofibrosis; economic cost; iron chelation therapy; medical resource utilization; transfusion dependent