The economic impact of multiple myeloma in the Brazilian private health care system

Abstract

Objectives: To evaluate the economic impact of multiple myeloma (MM) in the Brazilian private health care system. Methods: The Orizon database, an administrative claims database containing inpatient and outpatient data, was retrospectively analyzed from Jan/2013 to Aug/2016. The databa[1]se included patients who had been diagnosed with MM (ICD-10 C90.0) during the aforementioned timeframe and all subsequent procedures performed by the patient after the diagnosis. Eligibility criteria were patients with MM (ICD-10 code C90.0) treated between Jan/2013 and Jun/2015, who were followed by at least 365 days (1 year) and had at least one claim during this period. Outcome was direct medical costs (DMC) per patient-year, calculated as the sum of the medical claims for each patient included in the analysis divided by total patient-years, for a maximum period of 12-months. DMC was categorized in exams, procedures, medications (including chemotherapy and other medications) and other cost (materials, medicinal gases, packages and others costs). Further analysis was conducted for chemotherapy and hospitalizations. Results: From 1,332 patients with MM identified in the database, 973 met the eligibility criteria and were included in the analysis. Total DMC in this population was R$ 124,144 per patient-year, from which R$ 66,757 (54%) were related to medications, R$ 45,474 (37%) to hospitalizations and R$ 11,912 (10%) to other outpatient costs. A total of 3,050 hospitalizations were identified in 741 (76%) patients, with an average cost of R$ 23,151 per hospitalization. Conclusions: Patients with MM represent a significant economic burden to private payers. Drugs and hospitalization costs accounts for 90% of the total costs.