Economic and Clinical Burden of Virus-Associated Hemorrhagic Cystitis in Patients Following Allogeneic Hematopoietic Stem Cell Transplantation in the United States

• DOI: 10.1016/j.jtct.2021.02.021
• Publication Date: 2021-02-26T10:34:49Z
• Authors: Joseph McGuirk; Clint Divine; Seung Hyun Moon; Aastha Chandak; Zhiji Zhang; Genovefa A. Papan...
• Keywords: Hemorrhagic cystitis; Reimbursement

Hemorrhagic cystitis (HC) caused by viral infections such as BK virus, cytomegalovirus, and/or adenovirus after allogeneic hematopoietic stem cell transplantation (allo-HCT) causes morbidity and mortality, affects quality of life, poses a substantial burden to the health care system. At present, HC management is purely supportive, there are no approved or recommended antivirals for virus-associated HC. The objective this retrospective observational study was compare economic burden, resource utilization (HRU), clinical outcomes among allo-HCT recipients with those without using large US claims database. Claims data obtained from Decision Resources Group Real-World Evidence Data Repository were used identify patients first (index) procedure January 1, 2012, through December 31, 2017. Outcomes examined 1 year included total reimbursements, HRU, versus without. Further, generalized linear model determine adjusted reimbursements stratified presence absence any acute chronic graft-versus-host disease (GVHD) adjusting age, plan, underlying disease, source, number comorbidities, baseline follow-up time. Of 13,363 recipients, 759 (5.7%) met prespecified criteria Total unadjusted mean reimbursement $632,870 $340,469 In multivariable model, confounders, significantly higher GVHD compared (P < .0001). Patients stayed 7.9 additional days in hospital .0001) 6.1 = .0009) intensive unit (ICU) index hospitalization, readmission rate .0001), resulting 12.9 more 7.3 ICU hospitalization. Among GVHD, had all-cause mortality (23.2% 18.4%; P .0035). an analysis, risk regardless GVHD. When significant differences renal impairment; associated increased impairment period .0001 both). After allo-HCT, have worse outcomes, including impairment, irrespective Our results highlight unmet need effective strategies prevent treat HCT that may also reduce costs these patients.