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

Author

Listed:
  • Frida Schain

    (Janssen Global Services
    Karolinska Institutet
    Schain Research)

  • Nurgul Batyrbekova

    (Karolinska Institutet
    Scandinavian Development Services)

  • Johan Liwing

    (Janssen Global Services
    Karolinska Institutet)

  • Simona Baculea

    (Janssen Global Services)

  • Thomas Webb

    (Janssen Global Services)

  • Mats Remberger

    (Uppsala University)

  • Jonas Mattsson

    (Karolinska Institutet
    University of Toronto
    University of Toronto)

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.

Suggested Citation

  • Frida Schain & Nurgul Batyrbekova & Johan Liwing & Simona Baculea & Thomas Webb & Mats Remberger & Jonas Mattsson, 2021. "Real-world study of direct medical and indirect costs and time spent in healthcare in patients with chronic graft versus host disease," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(1), pages 169-180, February.
  • Handle: RePEc:spr:eujhec:v:22:y:2021:i:1:d:10.1007_s10198-020-01249-x
    DOI: 10.1007/s10198-020-01249-x
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    References listed on IDEAS

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    1. Bangzhu Zhu & Runzhi Pang & Julien Chevallier & Yi-Ming Wei & Dinh-Tri Vo, 2019. "Including intangible costs into the cost-of-illness approach: a method refinement illustrated based on the PM2.5 economic burden in China," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(4), pages 501-511, June.
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    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Rita Faria’s journal round-up for 8th February 2021
      by Rita Faria in The Academic Health Economists' Blog on 2021-02-08 12:00:01

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    More about this item

    Keywords

    Chronic graft versus host disease; Economic burden; Direct medical costs; Indirect costs; Sweden;
    All these keywords.

    JEL classification:

    • E24 - Macroeconomics and Monetary Economics - - Consumption, Saving, Production, Employment, and Investment - - - Employment; Unemployment; Wages; Intergenerational Income Distribution; Aggregate Human Capital; Aggregate Labor Productivity
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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