Cost Implications of Comorbidity for Autologous Stem Cell Transplantation in Elderly Patients with Multiple Myeloma Using SEER-Medicare
| Autor: | Rachel J. Buchsbaum, Pei-Jung Lin, Andreas K. Klein, Kellie Sprague, Susan K. Parsons, Joshua T. Cohen, Gunjan L. Shah, Aaron N. Winn, Hedy Smith, Raymond L. Comenzo, Kenneth B. Miller |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Article Subject Immunology Seer medicare 03 medical and health sciences 0302 clinical medicine Autologous stem-cell transplantation Older patients Internal medicine medicine Cost implications Multiple myeloma business.industry lcsh:RC633-647.5 Cell Biology Hematology lcsh:Diseases of the blood and blood-forming organs medicine.disease Comorbidity 3. Good health Surgery 030220 oncology & carcinogenesis Charlson comorbidity index Cost of care business 030215 immunology Research Article |
| Zdroj: | Bone Marrow Research Bone Marrow Research, Vol 2016 (2016) |
| ISSN: | 2090-2999 |
| DOI: | 10.1155/2016/3645623 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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