Cost Implications of Comorbidity for Autologous Stem Cell Transplantation in Elderly Patients with Multiple Myeloma Using SEER-Medicare. (18th October 2016)

• Record Type: Journal Article
• Authors: Shah, Gunjan L.; Winn, Aaron; Lin, Pei-Jung; Klein, Andreas; Sprague, Kellie A.; Smith, Hedy P.; Buchsbaum, Rachel; Cohen, Joshua T.; Miller, Kenneth B.; Comenzo, Raymond; Parsons, Susan K.
• Other Names: De Fabritiis Paolo Academic Editor.
• Is Part Of: Bone marrow research. Volume 2016(2016)
• Publication Date: 2016-10-18
• Subjects: Bone marrow -- Periodicals; 616.41
• DOI: 10.1155/2016/3645623
• Languages: English
• ISSNs: 2090-2999

Abstract

Abstract : Comorbidity is more common in older patients and can increase the cost of care by increasing toxicity. Using the SEER-Medicare database from 2000 to 2007, we examined the costs and life-year benefit of Auto-HSCT for MM patients over the age of 65 by evaluating the difference over time relative to comorbidity burden. One hundred ten patients had an Auto-HSCT in the early time period (2000–2003) and 160 in the late time period (2004–2007). Patients were divided by a Charlson Comorbidity Index (CCI) of 0 or greater than 1 (CCI1+). Median overall survival was 53.5 months for the late time period patients compared to 40.3 months for the early time period patients (p = 0.031 ). Median costs for CCI0 versus CCI1+ in the early period were, respectively, $70, 900 versus $72, 000 (100 d); $86, 100 versus $98, 300 (1 yr); and $139, 200 versus $195, 300 (3 yrs). Median costs for late period were, respectively, $58, 400 versus $60, 400 (100 d); $86, 300 versus $77, 700 (1 yr); and $124, 400 versus $110, 900 (3 yrs). Comorbidity had a significant impact on survival and cost among early time period patients but not among late time period patients. Therefore, older patients with some comorbidities can be considered for Auto-HSCT depending on clinical circumstances.