Cost Burden for Patients With Blood Cancers Eclipses the Burden in Other Cancers

Patients with blood cancers are burdened with higher costs than other cancers, and spending in blood cancers does not return to precancer levels, according to a new study from the Leukemia & Lymphoma Society (LLS).

The study received support from Pfizer, Genentech, and Amgen, and it examined the amount paid by payer and patient combined (total healthcare allowed spending) and patient out-of-pocket (OOP) costs for 5 blood cancer categories: acute leukemia, chronic leukemia, lymphoma, multiple myeloma, and bone marrow disorders.

The study used real-world claims data of 2332 patients with blood cancer with commercial insurance who were initially diagnosed in 2014. Lymphoma accounted for the majority of patients (63%), followed by chronic leukemia and multiple myeloma (12% each), and acute leukemia and bone marrow disorders (6% each).

On average, spending per patient in the first year after diagnosis was $156,000, and spending over the 3 years following diagnosis varied widely from $200,000 for chronic leukemia to more than $800,000 for acute leukemia. Before their diagnosis, patients spent an average of $1600 per month or less, and by the third year after diagnosis, these patients were still averaging spending between $3500 and $4500 per month.

The most expensive time for a patient with blood cancer was the month of diagnosis, the study found. Inpatient hospital services accounted for the majority (55%) of total allowed spending in the month of diagnosis. After that, anticancer drug therapy accounts for approximately one-third of total allowed spending. While total allowed spending decreases over time, they never return to prediagnosis levels, according to the report.

In the first year after diagnosis, patients with acute leukemia had the highest allowed spending ($463,414 vs $156,845 average for all blood cancers) and highest OOP ($5147 vs $3877 average for all blood cancers). However, over time, patients with multiple myeloma incur more OOP costs. Accumulated OOP costs for 3 years following diagnosis was $8797 for patients with acute leukemia and $9127 for patients with multiple myeloma. The average for other blood cancers over the 3 years following diagnosis was $7800.

The study also analyzed the impact of insurance design. Patients with high-deductible plans had OOP costs that were 64% higher than patients in traditional plans and it was worse for patients with acute leukemia, who had OOP costs in high-deductible plans that were more than double the costs in traditional plans.

“We at LLS frequently hear from blood cancer patients about the rising costs associated with lifesaving treatment,” LLS Chief Medical Officer Gwen L. Nichols, MD, said in a statement. “As this new study shows, each player in the healthcare system has a role to play in lowering these costs so patients can access their care. Armed with this data, LLS looks forward to continuing to work with stakeholders across the oncology ecosystem on solutions that put patients at the forefront in addressing the unsustainable cost of cancer care.”