Fewer blood transfusions for AML patients has humanistic and economic benefits

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The posters presented at the 2021 Academy of Managed Care Pharmacy Nexus meeting analyzed the perspectives of patients and physicians on blood transfusions in acute myeloid leukemia (AML).

As acute myeloid leukemia (AML) progresses and blood counts are affected by cytotoxic chemotherapy drugs, patients frequently receive blood transfusions. Two posters presented at the Nexus 2021 meeting of the Academy of Managed Care Pharmacy analyzed the views of patients and physicians on blood transfusions in AML.

The first poster, which received the bronze poster award, used online surveys as part of a preference study to understand the impact of attributes, such as transfusion independence, on preferences treatment of patients and doctors.1

A total of 77 patients newly diagnosed with AML but not eligible for high intensity chemotherapy (HIC) were included, along with 145 physicians. Researchers examined patient and physician views on the impact of transfusions on treatment attributes, as well as patient views on quality of life (QOL) and out-of-pocket expenses (US only ).

Patients were more likely to rate transfusion independence as very important (62.3%) compared to physicians (46.9%). Three-quarters (75.3%) of patients reported ≥ 1 transfusion in the past 3 months, and of these, 62.8% said the transfusions had at least somewhat affected their quality of life. Most patients (62%) reported receiving less than 4 transfusions per month. Activity was impaired due to the transfusion a third of the time (34.7%).

Of the 47 US patients, 35 had reported ≥ 1 transfusion in the past 3 months and 28 (80%) noted that their monthly infusion costs exceeded $ 500, 13 (37.1%) reporting costs in excess of $ 2,000 .

“Treatments that increase transfusion independence have both humanistic and economic benefits for AML patients who are not eligible for HIC,” the authors concluded.

In the second poster, the same researchers assessed the same issues in the context of maintenance treatment for AML after hematopoietic stem cell transplantation (HSCT).2 A total of 78 patients (US, n = 46; UK, n = 30; Canada, n = 2) and 145 physicians (US, n = 48; UK, n = 52; Canada, n = 29; Australia, n = 16) were included. Among patients, the mean duration of AML was 34 months and 32.1% of patients were not receiving treatment for AML.

Again, patients were more likely to rate transfusion independence as very important (46.2%) compared to physicians (39.3%). A majority (60.3%) of patients reported receiving ≥ 1 transfusion in the past 3 months and less than half (42.6%) reported receiving transfusions less than 4 times per month.

Of the 47 patients who received transfusions in the past 3 months, 59.6% reported that the quality of life was at least somewhat affected. Activity was impaired due to the transfusion 41.7% of the time, on average. Almost all of the US-based patients (94.6%) reported their monthly transfusion costs to be over $ 500, with 43.2% of reporting costs over $ 2,000.

The authors also concluded that there are humanistic and economic benefits for these patients to have maintenance treatments for AML that decrease transfusions after HSCT.

“Although few patients received transfusions, the transfusions had a negative impact on the patients’ quality of life and their ability to participate in daily activities,” they wrote.

The references

1. Yang H, Zhou M, Marshall DA, et al. Impact of blood transfusions on treatment characteristics, quality of life (QoL) and reimbursable costs in newly diagnosed acute myeloid leukemia (AML) ineligible for high intensity chemotherapy (HIC): patient and physician perspectives . Presented at: AMCP Nexus 2021; Denver, Colorado; October 18-21, 2021. Poster C40.

2. Zhou M, Yang H, Song Y, et al. Patient and Physician Perspectives on Treatment Attributes and the Humanistic and Economic Burden of Blood Transfusions in Patients with Acute Myeloid Leukemia (AML) Previously Treated with Hematopoietic Stem Cell Transplantation (HSCT). Presented at: AMCP Nexus 2021; Denver, Colorado; October 18-21, 2021. Poster C46.


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