The cost of care for acute lymphoblastic leukemia (ALL) is higher for patients diagnosed after age 9, according to a real-world analysis published in JCO Oncology Practice.
The cost of care was 50% to 70% higher among patients aged 10-30 years at diagnosis, compared with patients who were younger than 10 years of age, researchers found.
For this study, researchers analyzed commercial insurance data from OptumLabs Data Warehouse on 927 patients with ALL diagnosed from 1993 to 2017. The median age at baseline was 6 years (range, 1-30), and 43% of patients were female. All patients had 36 months of continuous insurance coverage, and none had undergone hematopoietic cell transplant.
The 36-month median inflation-adjusted cost of care was $394,000 in this cohort. More than 60% of costs were incurred during the first 8 months of cancer treatment.
When compared with patients aged 1-9 years, the 36-month cost was 1.5-fold higher for patients who were 10-12 years of age and 1.7-fold higher for patients who were 13 years of age or older.
The median total cost of care at 36 months was $695,000 for patients age 13 and older, $515,000 for patients aged 10-12 years, and $338,000 for patients aged 1-9 years.
Median outpatient costs at 36 months were $187,000 for the cohort overall, $171,000 for patients aged 1-9 years, $221,000 for those aged 10-12 years, and $274,000 for those age 13 and older.
Median inpatient costs at 36 months were $180,000 for the cohort overall, $148,000 for patients aged 1-9 years, $278,000 for those aged 10-12 years, and $310,000 for those age 13 and older.
When compared with patients aged 1-9 years, patients aged 10-12 years had 23.5 more inpatient days at 36 months, and patients who were 13 years or older had 25.2 more inpatient days at that time point.
The median number of inpatient days for the entire cohort was 39 days, and most hospitalizations occurred within the first 8 months of treatment (median, 30 days).
“This real-world cohort of commercially insured children, adolescent, and young adult patients with ALL represents one of the largest samples used to date in examining the cost of ALL care in the United States,” the researchers wrote. “These data provide valuable benchmarks for future studies examining the cost-benefit of ALL therapy modifications.”
The researchers noted, however, that this study did not address direct costs to the patient, and this parameter should be considered in future analyses of ALL costs.
Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
Turcotte LM, Watson D, Tanner L, et al. Real-world cost of pediatric acute lymphoblastic leukemia care among commercially insured individuals in the United States: Effect of era and age at diagnosis. JCO Oncol Pract. Published online September 27, 2022. doi:10.1200/OP.22.00344