Physician groups, as well as payers, have changed to quality-based and bundled-care or episodic models in order to decrease the cost of healthcare and improve care. These models may be influenced by the progression of the disease and its corresponding costs. This is especially the case if these programs do not take the severity of the disease and progression risk within the cohort into consideration. For this study, estimation was made regarding the incremental cost of the progress of a disease in patients who were diagnosed with acute myeloid leukemia (AML), chronic lymphoid leukemia (CLL), and non-Hodgkin’s lymphoma (NHL). A comparison was later made between patients who suffered from a progression in their disease and patients who did not suffer from disease progression.

This was a backdated study between 1st July 2006 and 31st August 2014. It was conducted through the utilization of data of U.S administrative cases which was collected from commercial and Medicare Advantage health care patients. These patients were diagnosed with AML, NHL, and CLL, and also happened to have used systemic antineoplastic agents. 12-month health care costs, disease progression, and 3-year cumulative predictive health care costs were the outcomes of the study.

Signs of progression in disease were found in 31.1% of 1,056 patients with CLL, 63.8% of 514 patients with AML, and 36.9% of 7,601 patients with NHL. Adjusted and unadjusted health care costs were notably greater amidst progressors in comparison to nonprogressors among the patients who had CLL and NHL. Patients with CLL, NHL, and AML had nearly twice the per-patient-per-month costs, taking the variable follow-up time into consideration if their disease progressed in comparison to nonprogressors. Health care costs were lower in all three types of cancer patients who had a long delay in the progression of their disease.

Over a 12-month period, progression of CLL, NHL, and AML was related to an increase in health care costs. There was a considerable decrease in costs for patients with all three cancer types as a result of the delay in cancer progression.

Link:theoncologist.onlinelibrary.wiley.com/doi/10.1634/theoncologist.2018-0019

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