MedicalResearch.com Interview with:
Dr. Jonathan Schelfhout, PhD
Director, Outcomes Research
Merck & Co. Inc.
North Wales, PA
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The cost of hematopoietic stem cell transplantation has received increased attention after it was identified as a top 10 contributor to increasing healthcare costs in an AHRQ 2016 report. Many recent studies have explored the cost of HSCT but additional research is needed on the costly complications that can follow the transplant procedure. This research is particularly relevant for inpatient decision makers, as most transplant centers receive one bundled payment for the transplant and the treatment of any complications over the first 100 days.
MedicalResearch.com: What should clinicians and patients take away from your report?
Response: Cytomegalovirus is a substantial contributor to the overall cost of hematopoietic stem cell transplantation and a major driver of increased healthcare resource utilization in the first 100 days post-transplant. Our study revealed that allogeneic HSCT recipients with a CMV infection in the post-transplant period were more than twice as expensive to the transplanting hospital than hematopoietic stem cell transplantation recipients who did not have a CMV infection. The additional $65,666 cost of these patients was driven by an increase in hospital admissions and total length of stay, and is likely to place a substantial economic burden on the transplanting hospital. Cost and healthcare resource utilization was even higher for the 25% of these patients who went on to have multiple CMV infections, as these patients had nearly 4 times higher cost to the inpatient setting than patients with no CMV infection.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Future research should continue to explore the patient and institutional characteristics that are related to increased healthcare resource utilization and cost. It will also be important to explore the outpatient costs that are borne by the recipients insurance provider, as these were not captured in this study and are likely to be significantly higher than the inpatient costs given the increased scope and longer timeframe.
MedicalResearch.com: Is there anything else you would like to add?
Response: I would encourage any transplant centers with access to cost or resource utilization data to investigate and publish their local findings on the impact of CMV and other complications. A strength of using a large inpatient database was that we could analyze these costs across a wide range of patients and institutions, but more granular data could be valuable for better understanding the individual treatments or patient characteristics contributing to the increased cost.
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Citation: IDWeek 2017 abstract
2436. Cost of Hematopoietic Stem Cell Transplant and Cytomegalovirus Related Complications in a Large Inpatient Claims Database
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