Patient characteristics, burden of disease, healthcare resource utilization and costs in acute myeloid leukemia - a retrospective observational study with German claims data.

Aim: To assess patient characteristics, burden of disease, healthcare resource utilization and costs of acute myeloid leukemia (AML) by treatment intensity in German claims data. Materials & methods: In this retrospective cohort study using claims data from the German sickness fund AOK PLUS, we identified incident AML patients between 2012 and 2022. Incident AML patients were stratified into groups receiving intensive chemotherapy (IC) or nonintensive therapy (NIC). We then conducted descriptive analyses of patient characteristics, disease burden, including blood and platelet transfusions, healthcare resource utilization and costs. Results: We identified 1533 incident AML patients who received treatment (male: 53%; mean age: 67.7 years; median Charlson comorbidity index [CCI]: 5.0), corresponding to an incidence rate of 4.4/100,000. A total of 688 patients (44.9%) were categorized as IC, 845 patients (55.1%) as NIC. Notably, 860 additional patients (male: 48%; 78.0 years; median CCI: 5.0) had no relevant treatment code. NIC patients were older than IC patients (78.0 vs 61.0 years) and had a higher comorbidity burden (median CCI: 6.0 vs 4.0). NIC patients were hospitalized to a lesser extent (81.3% vs 87.9%), had shorter lengths of stay (64.0 vs 103.1 days/patient-year [PY]) and lower hospitalization costs/PY (56,063€/PY vs 110,186€/PY) compared with IC patients. Anemia and thrombocytopenia (NIC: 40.5 and 39.5%, IC: 76.9 and 42.6%) as well as blood and platelet transfusions were common, especially among IC patients (NIC: 93.0 and 74.3%, IC: 99.4 and 98.5%). Conclusion: Compared with IC patients, NIC patients were older, had a higher comorbidity burden and fewer hospitalizations. Combined with the high number of older patients not receiving AML treatment, this points to a lack of adequate treatment options for this patient population. The high rates of blood and platelet transfusions, particularly among IC patients, underscore the high disease burden and emphasize the need for better-tolerated therapies.