Burden of myelodysplastic syndromes: a systematic literature review of economic burden

Objective To identify and synthesize available evidence on the economic burden for myelodysplastic syndromes (MDS). Methods A systematic search was conducted in EMBASE and MEDLINE on July 13, 2021 to identify studies that report original data on the economic burden of MDS. Included studies were reviewed independently and in duplicate by two reviewers. Data on study design, patient characteristics and economic burden were extracted using a standardized form developed by the team. All costs were converted to 2023 USD and then a descriptive analysis was conducted. Results 77 publications from 61 unique studies reporting the economic burden of MDS were identified. Most were database studies (n = 34, 55.7%) and were conducted in the United States (n = 34, 55.7%). The most common outcome considered was total costs for MDS (n = 32, 52.5%). Total annual costs ranged from $6777 to $521,141 and differed according to treatment modality [best supportive care versus hypomethylating agents (HMAs)] and patient status (risk status and transfusion dependent). Broadly, costs were greater among patients with high-risk MDS compared to low-risk patients as well as those receiving HMAs and transfusions. Other costs and resource use outcomes (outpatient, inpatient costs, etc.) were not directly comparable across studies due to heterogeneity and lack of reporting of cost components. Conclusion This systematic literature review provides insight into the economic burden of MDS, which can be substantial. More research is needed to explore specific cost components as well as economic outcomes among subgroups of patients, such as newly diagnosed patients or patients classified as high risk.