Abstract
Objective: Anaemia is a common haematological complication of cancer and cytotoxic treatment. The incremental economic burden associated with medical care and short-term disability of anaemia in patients with malignancy and receiving chemotherapy has not been well documented. This study evaluates the effect of anaemia on the costs associated with cancer treated with chemotherapy.
Methods: Patients receiving chemotherapy within 6 months of their initial cancer diagnosis were identified in a commercial claims database for 1999–2000. Data for these individuals were linked to their employers’ short-term disability records via unique encrypted personal identification numbers provided by employers. Patients with anaemia were identified by a diagnosis of anaemia or treatment with transfusion or erythropoietin alfa (EPO). Healthcare expenditure and short-term disability leave were observed for up to 6 months following initial cancer diagnosis and were summarised into monthly averages. Exponential conditional mean models and zero-inflated negative binomial models were used to analyse mean monthly healthcare expenditures and short-term disability days.
Results: Twenty-five percent of the 619 newly diagnosed cancer patients treated with chemotherapy had anaemia. The presence of anaemia and longer length of transfusion therapy were associated with increased expenditures, while longer length of EPO treatment was associated with lower expenditures. The incremental costs due to anaemia among patients receiving chemotherapy were $US5538 (year 2001 values) per month in the first 6 months following cancer diagnosis, 10.8% of which were costs related to short-term disability leave.
Conclusion: Anaemia in patients undergoing chemotherapy presents a substantial burden to employers and payers. The findings also suggest that patients with anaemia treated with erythropoietin alfa can achieve expenditure levels similar to those patients without anaemia.
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Acknowledgements
This research was supported by Amgen, Inc. Ernst Berndt, William Crown and Joel Kallich all participated in the design, execution and analysis of the study Ernst Berndt is a consultant to both Amgen and Medstat, William Crown is an employee of Ingenix and Joel Kallich is an employee of Amgen.
Stacey Long and Xue Song were responsible for the statistical analysis and have no individual conflicts of interest. Their employer, Medstat, received funding from Amgen to conduct the study. Gary Lyman participated in the study design, analysis and the review and editing of the final manuscript. He is on the Speaker’s Bureau for Amgen and has previously received grant funding from Amgen.
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Berndt, E., Crown, W., Kallich, J. et al. The impact of anaemia and its treatment on employee disability and medical costs. Pharmacoeconomics 23, 183–192 (2005). https://doi.org/10.2165/00019053-200523020-00009
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DOI: https://doi.org/10.2165/00019053-200523020-00009