Real-world treatment and utilization of venetoclax for incident acute myeloid leukemia in a Medicare population.

AIMS: This study aimed to describe first-line venetoclax in the Medicare population and its impacts on treatment patterns, utilization, and costs. MATERIALS AND METHODS: This retrospective cohort study used Medicare Fee-For-Service data from 1 September 2016, to 31 December 2022. Patients were continuously-enrolled, had incident acute myeloid leukemia (AML) and no confounding diagnoses, and were treated with first-line venetoclax-based regimens. Initiation of second line of therapy was modeled using cumulative incidence functions. RESULTS: Among 2,765 included patients, median age was 76 years. Median venetoclax dosage was 140.4 mg/day - lower than the 400-600 mg/day recommended by clinical guidelines. Patients were less likely to initiate second-line therapy if they were older or had more comorbidities.Patients had a per-month median of 5.3 outpatient visits, 0.3 emergency department visits, and 0.2 hospitalizations; length of stay was 10 days. Mean monthly healthcare costs were $18,092 (SD=$14,289) per patient, with $12,042 (SD=$12,147) and $6,050 (SD=$7,841) attributable to medical services and drug costs, respectively. CONCLUSIONS: A growing number of patients enrolled in Medicare Fee-For-Service with AML use first-line venetoclax. Older patients and those with comorbidities are less likely to initiate second-line therapy. Costs were lower and length of stay was shorter than described in previous research.