Real-world study of direct medical and indirect costs and time spent in healthcare in patients with chronic graft versus host disease

Frida Schain (), Nurgul Batyrbekova, Johan Liwing, Simona Baculea, Thomas Webb, Mats Remberger and Jonas Mattsson
Additional contact information
Frida Schain: Janssen Global Services
Nurgul Batyrbekova: Karolinska Institutet
Johan Liwing: Janssen Global Services
Simona Baculea: Janssen Global Services
Thomas Webb: Janssen Global Services
Mats Remberger: Uppsala University
Jonas Mattsson: Karolinska Institutet

The European Journal of Health Economics, 2021, vol. 22, issue 1, No 12, 169-180

Abstract: Abstract Chronic graft versus host disease (cGVHD) is a debilitating and costly complication following haemopoietic stem cell transplantation (HSCT). This study describes the economic burden associated with cGVHD. Direct costs associated with specialised healthcare utilisation (inpatient admissions and outpatient visits), as well as indirect costs associated with sickness absence-associated productivity loss were estimated in patients who underwent allogeneic HSCT in Sweden between 2006 and 2015, linking population-based health and economic registers. To capture the period of chronic GVHD, patients were included who survived > 182 days post-HSCT (start of follow-up), and cGVHD was classified based on patient treatment records to correct for any diagnosis underreporting. Patients were classified as ‘non-cGVHD’ if they received no immunosuppressive treatment, ‘mild cGVHD’ if they received only systemic corticosteroid treatment or immunosuppressive treatment, or ‘moderate–severe cGVHD’ if they received extracorporeal photopheresis (ECP) only, corticosteroid treatment and immunosuppressive treatment, or systemic corticosteroid treatment and ECP treatments. Patients with moderate–severe cGVHD spent more time in healthcare, had higher healthcare resource costs and higher sickness absence-related productivity loss compared to patients with non- or mild cGVHD. The cumulative total costs during the first 3 years of follow-up were EUR 14,887,599, EUR 20,544,056, and EUR 47,811,835 for non-, mild, and moderate–severe groups, respectively. The long-term costs incurred with cGVHD following HSCT continue to be very high and significantly impacted by cGVHD severity. This study adds real-world health resource and economic insight relevant for policy-makers and healthcare providers when considering the clinical challenge of balancing immunosuppression to reduce cGVHD.

Keywords: Chronic graft versus host disease; Economic burden; Direct medical costs; Indirect costs; Sweden (search for similar items in EconPapers)
JEL-codes: E24 H51 I18 (search for similar items in EconPapers)
Date: 2021
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DOI: 10.1007/s10198-020-01249-x

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