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Real-world clinical characterization, healthcare resource utilization and productivity loss in chronic graft versus host patients exposed to extracorporeal photopheresis in Sweden
Schain Res, Sweden.
Karolinska Inst, Sweden.
KTH Royal Inst Technol, Sweden.
KTH Royal Inst Technol, Sweden.
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2023 (English)In: Transfusion and apheresis science, ISSN 1473-0502, E-ISSN 1878-1683, Vol. 62, no 3, article id 103705Article in journal (Refereed) Published
Abstract [en]

Background: Extracorporeal photopheresis (ECP) is frequently used to treat moderate-severe chronic graft versus host disease (cGVHD), however limited data exists describing ECP treatment effects on healthcare and societal costs. We aimed to characterize clinical and health economic outcomes and productivity loss in cGVHD patients exposed to ECP.Methods: We identified 2708 patients aged & GE; 18 years with a record of allogeneic hematopoietic stem cell transplantation (HSCT) in the Swedish Patient Register between 2006 and 2020. Patients exposed to ECP from 3 -months post HSCT (index) were included (n= 183). Data was linked to the Prescribed Drug Register, the Cause of Death Register, and the Longitudinal Integrated Database for Health Insurance and Labor Market Studies (LISA).Results: The median patient age at index was 51 years (IQR1-3; 38-61). In the 3-month period before ECP initiation compared to 9-12 months post-ECP, the cumulative three-month dose per patient decreased pred-nisolone/prednisone (1,381 mg vs. 658 mg, p < 0.001) and cyclosporin (12,242 mg vs. 3,501 mg, p < 0.001). Infection incidence also decreased over the same period (79.2% vs 59.1%, p < 0.001). Time spent in healthcare decreased from 68.9% to 22.1% from the first and fifth follow-up year respectively, and corresponding annual healthcare cost reduced from euro27,719 to euro1,981. Among patients < 66 years of age, sickness-related workplace absence decreased from 73.2% to 31.9% between the first and fifth follow-up year, with median annual pro-ductivity loss decreasing from euro20,358 to euro7,211 per patient.Conclusions: ECP was associated with reduced use of corticosteroids, immunosuppressive agents, and fewer in-fections. Furthermore, cost and healthcare utilization decreased over time.

Place, publisher, year, edition, pages
PERGAMON-ELSEVIER SCIENCE LTD , 2023. Vol. 62, no 3, article id 103705
Keywords [en]
Extracorporeal photopheresis; Healthcare resource utilization; Hematopoietic stem cell transplantation; Population -based registry; Chronic graft versus host disease
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Surgery
Identifiers
URN: urn:nbn:se:liu:diva-196849DOI: 10.1016/j.transci.2023.103705ISI: 001012895700001PubMedID: 36967367OAI: oai:DiVA.org:liu-196849DiVA, id: diva2:1791200
Available from: 2023-08-24 Created: 2023-08-24 Last updated: 2024-01-11

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Berlin, Gösta
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Division of Inflammation and InfectionFaculty of Medicine and Health SciencesDepartment of Clinical Immunology and Transfusion Medicine
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