ALBERT

Description: Abstract 2060 Background: Three subtypes of MPN (myelofibrosis (MF), polycythemia vera (PV) and essential thrombocythemia (ET)) are characterized by activation of JAK2 signaling, with the majority having the JAK2 V617F mutation. Median survival in these subtypes ranges from months to years for MF (Gangat JCO 2011) and up to a decade or more for some patients with PV and ET. Some symptomatic treatment options exist, but with the exception of hematopoietic stem cell transplant, none are curative. Little is known about healthcare costs associated with these diseases. Objective: To compare annual medical and pharmacy costs in three subtypes of MPN patients (MF, PV, ET) to matched non-cancer controls using a large US commercial claims database. Methods: Data were drawn from the Thomson Reuters MarketScan database, which contains claims for insured employees, retirees and dependents from approximately 100 US payers. Index date was the first claim with an MPN diagnosis code in the time period 2005 to 2008. Eligible patients had one year continuous enrollment post-index with no evidence of non-AML secondary malignancy. Controls had one year of continuous enrollment after their match date and were matched to patients in a ratio of 5:1 based on gender, year of birth, geographic region and insurance type (Comprehensive, Health Maintenance Organization, Preferred Provider Organization, etc.). Controls were excluded if they had a service claim with a diagnosis for cancer or a pharmacy claim for chemotherapy. Costs were based on total gross payments to the provider, which equals the amount eligible for payment under the medical plan terms after applying rules for discounts, but before applying coordination of benefits, copayments and deductibles. Total cost was the sum of MPN and non-MPN related medical costs which included inpatient, outpatient and emergency room service and pharmacy. Pharmacy included injectable and non-injectable chemotherapy, supportive care and other prescription drug costs. Results: A total of 25,145 MPN patients (MF: 509, PV: 16,165, ET: 8,471) were included and assigned matching controls. The mean cost (standard deviation) for cases and controls are shown in the table. Medical and Pharmacy Costs: Conclusions: Annual medical and pharmaceutical costs for patients with MPNs are 2 to 6 times those of matched non-cancer patients and represent medical management challenges and payer burden. Outpatient visits accounted for about half of the total healthcare costs, followed by inpatient visits, pharmaceutical costs and ER visits. Disclosures: Price: Elil Lilly and Company: Employment; Eli Lilly and Company: Equity Ownership. Pohl:Eli Lilly and Company: Employment; Eli Lilly and Company: Equity Ownership. Xie:Eli Lilly and Company: Employment; Eli Lilly and Company: Equity Ownership. Walgren:Eli Lilly and Company: Employment; Eli Lilly and Company: Equity Ownership.

Description: Background Existing data demonstrate that SREs can impose a significant economic burden. Much of the cost data for MM patients are combined with other tumor types and do not make comparisons between MM patients with SRE and MM patients without SRE. This research provides updated, comprehensive cost data in MM patients to address these gaps. Methods Patients 18 years of age or older were required to have ≥2 claims in any position with a diagnosis of MM (ICD-9-CM codes 203.00, 203.01, 203.02), at least 30 days apart, between 01 January 2005 and 31 December 2010; the date of the first MM diagnosis was the index date. Marketscan(r) data were used to select patients continuously enrolled in a non-capitated commercial health plan with a medical and pharmacy benefit for 12 months before the index date (i.e., baseline period) and at least 3 months after the index date (post-index period). Patients were followed until the earliest of death or disenrollment from the health plan or end of the study period on 31 December 2011. MM patients with ≥ 1 SRE were compared to those without SRE to characterize the associated incremental cost of SRE. Frequency of SREs, HCRU (events/person-mth), and costs (USD/person-mth) were determined. Cost is defined as total gross payment to providers for a specific service, which includes amount paid by the patient and payer. Due to skewed distributions, bootstrapping (replication=1000) methodology was used to estimate standard error of rates of HCRU and costs and to compare cohorts. P-values were generated utilizing 2-sample t-tests. Results MM patients with SRE (n=596, mean age=67.8, 45.6 % male, mean Charlson/Deyo [CD] =1.1) were compared to MM patients without SRE (n=432, mean age=65.7, 47.5 % male, mean CD=0.8). Patients are categorized by number of SREs experienced during the study period in Table 1. MM patients with SRE experienced significantly greater HCRU during both the baseline and post-index periods (Tables 2&3). The HCRU increases translated into mean total costs for patients with SRE that were significantly greater during both the baseline (w/o SRE: USD 953; w/SRE: USD 1328; p=0.005) and post-index (w/o SRE: USD 3307; w/SRE: USD 4763; p

Description: Abstract 3140 Background: Three subtypes of MPN (myelofibrosis (MF), polycythemia vera (PV) and essential thrombocythemia (ET)) are characterized by activation of JAK2 signaling, with the majority having the JAK2 V617F mutation. Patients diagnosed with MF, PV or ET are typically at higher risk for infections, cardiovascular complications, anemia and other comorbid diseases (Barosi Blood 2007, Vannucchi Blood 2007). However, comparative rates of these comorbidities are not well described in the literature. Objective: To compare comorbidity rates from three subtypes of MPN patients (MF, PV, ET) with matched non-cancer control groups using a large US commercial claims database. Methods: Data were drawn from Thomson Reuters MarketScan, which contains claims for insured employees, retirees, and dependents from approximately 100 US payers. Index date was the first claim with a diagnosis code for MPN in the time period 2005 to 2008. Eligible patients had 1 year of continuous enrollment post-index with no evidence of non-AML secondary malignancy. Patients were deemed to have a comorbidity if they had an ICD-9 diagnosis code that was on a list of pre-specified codes likely to be related to MPN for each comorbidity category. Controls had one year of continuous enrollment after their match date and were matched to patients in a ratio of 5 :1 based on gender, year of birth, geographic region and insurance type (Comprehensive, Health Maintenance Organization, Preferred Provider Organization, etc.). Controls were excluded if they had a service claim with diagnosis for cancer or a pharmacy claim for chemotherapy. Results: A total of 25, 145 MPN patients were included and assigned matching controls. For MF, PV and ET cases, respectively, mean age was 64.4, 54.4. 52.3 years and % female was 51.7, 36.1 and 70.7. Comorbidity rates during the study period for some diseases of interest in MPN patients and matched controls are shown in the table. Conclusion: Patients diagnosed with an MPN typically experienced significantly higher rates of comorbidities than non-MPN matched controls. These findings have implications for both the clinical management of MPN patients as well as for health economic assessments, since a substantial portion of the cost of care for MPN patients may reside in treatment of comorbidities not directly coded to MPN. Restricting patients and controls in this study to a single matching year of observation helped to align risk between cases and controls, but may have underestimated the total comorbidity burden that MPN patients could experience in their lifetime. Disclosures: Price: Elil Lilly and Company: Employment; Eli Lilly and Company: Equity Ownership. Pohl:Eli Lilly and Company: Employment; Eli Lilly and Company: Equity Ownership. Xie:Eli Lilly and Company: Employment; Eli Lilly and Company: Equity Ownership. Walgren:Eli Lilly and Company: Employment; Eli Lilly and Company: Equity Ownership.