Author:
Shen Shih-Pei,Hou Hsin-An,Huang Kuan-Chih,Goh Choo Hua,Qiu Hong,Rothwell Lee Anne,Wu Kwang-Wei,Chandwani Hitesh,Liu Yanfang,Tang Chao-Hsiun
Abstract
AbstractWe conducted a retrospective population-based, matched cohort study using the National Health Insurance Research Database to estimate healthcare resource utilisation (HRU) and costs in patients with newly diagnosed AL amyloidosis in Taiwan. Cases were matched 10:1 by age, sex, and area of residence to patients without AL amyloidosis (comparators) randomly selected from the database during the same time period. Annual all-cause HRU and costs for 3 years were quantified. AL amyloidosis-attributable costs were obtained by subtracting all-cause HRU costs incurred by comparators from cases. The mean age of all patients was 60.78 years and 59.07% were male. Co-morbidities were more frequent in cases than comparators. By 6 months after diagnosis, 12.1% of cases had died versus 0.9% of comparators. In the first year, cases had 103% more outpatient visits, 177% more emergency room visits, were hospitalised 4-times more frequently, and spent 5.5-times more days in hospital than comparators, and total healthcare costs were > sixfold higher. Costs incurred during the first year after diagnosis accounted for 55% of the 3-year cumulative cost. High HRU costs associated with delayed diagnosis and end-organ damage indicate a need for earlier diagnosis and more effective treatments for AL amyloidosis.
Publisher
Springer Science and Business Media LLC
Reference25 articles.
1. Hwa, Y. L. et al. Immunoglobulin light-chain amyloidosis: Clinical presentations and diagnostic approach. J. Adv. Pract. Oncol. 10, 470–481 (2019).
2. Hester, L. L. et al. Diagnostic delay and characterization of the clinical prodrome in AL amyloidosis among 1523 US adults diagnosed between 2001 and 2019. Eur. J. Haematol. 107, 428–435 (2021).
3. Hasib Sidiqi, M. & Gertz, M. A. Immunoglobulin light chain amyloidosis diagnosis and treatment algorithm 2021. Blood Cancer J. 11, 90 (2021).
4. Palladini, G., Milani, P. & Merlini, G. Management of AL amyloidosis in 2020. Hematol. Am. Soc. Hematol. Educ. Program 2020, 363–371 (2020).
5. Muchtar, E. et al. Ten-year survivors in AL amyloidosis: Characteristics and treatment pattern. Br. J. Haematol. 187, 588–594 (2019).