Costs of AML Treatment
The health care costs related to AML treatment are vastly complex, often separated into direct, including both medical and nonmedical, and indirect costs. Examples of direct costs include drug costs, diagnostic testing, and hospitalization; indirect costs are more difficult to assess but include measures such as loss of productivity for patients or caregivers. Clinical care provided in an inpatient setting is often more expensive than care provided an outpatient setting, but it may be necessary depending on the complexity of care or specific treatment regimen.
“Although inpatient therapy remains a major component of the management paradigm, [in] the last decade [we have] witnessed a shift in the management of older patients with AML from the inpatient to the outpatient setting,” said Dr Zeidan. “We are expecting a significant shift to outpatient therapy for AML patients, especially for older patients.”
With respect to direct health care costs, the economic burden and cost of illness are considerable. Various patient-specific factors affect these costs, including severity of disease, treatment strategy, country of origin, and insurance status; health policy and societal factors are also important. Furthermore, the current treatment landscape is rapidly changing, and ongoing advances in diagnostic testing have made reaching a consensus on cost-effectiveness challenging.
In the review, the authors reported that costs have now exceeded that of general inflation and will likely continue in an upward trajectory.
Clinical Perspectives and Moving Forward
“We believe that the lack of well-tolerated, effective oral therapies until recently is one [of the] major reasons why many older AML patients are not receiving active therapy,” Dr Zeidan said. “Our hope is the availability of multiple novel oral and active therapies will change this trend and lead to a significant increase in the proportion of patients receiving active therapies, and hopefully improve survival of this patient population.”
He added, “Close collaboration between policy makers, insurance carriers, manufacturers, and patient advocacy groups will be needed to maximize the benefits that our older AML patients will derive from these therapies.”
Other possible strategies to lower treatment costs include transitioning clinical care to outpatient settings, necessitating cost-effectiveness analysis, and consolidating drug procurement activities.
Bewersdorf JP, Shallis R, Wang R, et al. Health care expenses for treatment of acute myeloid leukemia [published online June 3, 2019]. Expert Rev Hematol. doi:10.1080/17474086.2019.162786
This article originally appeared on Hematology Advisor