ArticleJournal of managed care & specialty pharmacy2026
Health care resource utilization and costs in patients with acute myeloid leukemia treated with posttransplant maintenance therapy.
Article in Journal of managed care & specialty pharmacy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAllogeneic hematopoietic cell transplantation (allo-HCT) improves survival in patients with acute myeloid leukemia (AML); however, posttransplant relapse remains the most common cause of treatment failure and death. Limited data exist on posttransplant health care resource utilization (HCRU) and costs, particularly for patients initiating maintenance therapy.
objectiveTo describe HCRU and costs among commercially insured patients, Medicaid enrollees from participating US states, and Medicare-eligible beneficiaries with employer-sponsored supplemental coverage who received maintenance therapy after allo-HCT compared with those receiving allo-HCT alone.
methodsWe conducted a retrospective cohort study of patients with AML who underwent allo-HCT using claims data from the Merative MarketScan database from October 1, 2015, to March 31, 2024. Patients receiving maintenance therapy were identified by a claim for 1 of the following agents after allo-HCT: azacitidine, decitabine, enasidenib, gemtuzumab ozogamicin, gilteritinib, glasdegib, ivosidenib, midostaurin, quizartinib, sorafenib, or venetoclax. Groups were balanced using inverse probability treatment weighting (IPTW) based on baseline characteristics. We assessed differences in all-cause monthly HCRU and costs. HCRU included emergency department (ED) visits, inpatient (IP) admissions, outpatient (OP) visits, and hospital length of stay throughout the 12-month follow-up period. Poisson and negative binomial regression models estimated event rates. Per patient per month mean costs were reported with SEs, and between-group differences were assessed using mean differences, bootstrapped 95% CIs, and
resultsOf the 373 patients who met the inclusion criteria, 43 were prescribed maintenance therapy following allo-HCT. The maintenance therapy group demonstrated significantly higher HCRU across service types. Both office (incidence rate ratio [IRR] = 3.23,
conclusionsThose who received maintenance therapy following allo-HCT had higher IP admission and OP use rates and incurred more pharmacy costs. These findings highlight the need to balance the clinical benefits of maintenance therapy with its increased demands on health care resources.
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