Healthcare Resource Utilization Is High for Patients with Steroid-Resistant Chronic GVHD

Chronic graft-versus-host disease (GVHD) is considered the most serious non-relapse complication among patients who undergo allogeneic hematopoietic cell transplantation (alloHCT). Patients with steroid-resistant (SR) chronic GVHD use multiple lines of therapy and have significantly higher healthcare resource utilization (HCRU) compared with patients who do not have GVHD, according to a retrospective claims database analysis.

Patients aged ≥12 years who underwent alloHCT between January 1, 2010, and August 31, 2016, were identified using the Optum Research Database. Patients were diagnosed with chronic GVHD within the study period, unspecified GVHD beyond 120 days post-transplantation, or no GVHD at any time. Comparisons were made for all-cause HCRU and costs between patients with SR chronic GVHD (one-year analysis, n=296; two-year analysis, n=178) versus those without GVHD (n=227 and n=158, respectively).

During follow-up, three-quarters of patients with SR chronic GVHD were given at least four lines of therapy. Patients with SR chronic GVHD, compared with patients without GVHD, had significantly more median office visits (49 vs. 27), outpatient visits (69 vs. 24), emergency department visits (1 vs. 0), and inpatient admissions (2 vs. 1) within one year of transplantation (P<0.001 for all), as well as much higher HCRU within two years. Patients with SR chronic GVHD had significantly higher median total all-cause costs than patients with no GVHD at one ($372,254 vs. $219,593) and two years ($532,673 vs. $252,909) post-alloHCT.