title: Acute myeloid leukemia: a retrospective claims analysis of resource utilization and expenditures for newly diagnosed patients from first-line induction to remission and relapse.
abstract: The objective of this study was to estimate resource utilization and expenditures for patients with acute myeloid leukemia (AML) in a real-world claims database.
  
  
  
  AML patients were identified in MarketScan claims databases between 1 January 2009 and 31 January 2015. Patients had a minimum of two AML diagnosis codes, hospitalization within 14 days after initial diagnosis, and ≥6 months of enrollment before initial diagnosis. Patients were monitored from first-line induction to a record of remission. A subset had a record of a second treatment period, defined as time from relapse to remission. Patient demographics, AML risk factors, and comorbidities were recorded. Descriptive analysis of utilization and expenditures (in 2014 $US) were reported for each cohort.
  
  
  
  The inclusion criteria were met in 1597 patients (mean age, 58.4 years; 51.0% male). Ninety percent of patients had ≥1 risk factor for AML. Mean (SD) healthcare expenditures for patients from first-line induction to remission (n = 681) were $208,857 ($152,090). Of the 157 who had a record of relapse, 70 had a record of a second remission. Expenditures for these patients (n = 70) from relapse to remission were $142,569 ($208,307); 60% were admitted to a hospital for a mean of 18.5 hospital days, and 20% had ≥1 emergency room visit.
  
  
  
  Although this claims-based analysis is limited by a lack of generalizability to noninsured populations and potential underreporting of certain events and diagnoses, we found that treating AML patients poses a significant healthcare burden, during both first-line induction and relapse. With people living longer, the number of cases of AML is expected to increase in the future.
authors.affiliation: a CTI Clinical Trial and Consulting Services Inc. , Cincinnati , OH , USA.
authors.forename: William
authors.initials: W
authors.lastname: Irish
authors.affiliation: a CTI Clinical Trial and Consulting Services Inc. , Cincinnati , OH , USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Ryan
authors.affiliation: a CTI Clinical Trial and Consulting Services Inc. , Cincinnati , OH , USA.
authors.forename: Larry
authors.initials: L
authors.lastname: Gache
authors.affiliation: a CTI Clinical Trial and Consulting Services Inc. , Cincinnati , OH , USA.
authors.forename: Candace
authors.initials: C
authors.lastname: Gunnarsson
authors.affiliation: b Pfizer Inc , New York , NY , USA.
authors.forename: Timothy
authors.initials: T
authors.lastname: Bell
authors.affiliation: b Pfizer Inc , New York , NY , USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Shapiro
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005102:Health Expenditures; D006295:Health Resources / Q000706:statistics & numerical data*; D006801:Humans; D007345:Insurance Claim Review; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012074:Remission Induction; D012189:Retrospective Studies
keywords: Acute myeloid leukemia; Expenditures; Induction; Relapse; Remission; Utilization