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Indirect costs associated with premature mortality among those with veno-occlusive disease/sinusoidal obstruction syndrome with multiorgan dysfunction post-hematopoietic stem-cell-transplant

Authors Zhou ZY, Tang W, Villa KF

Received 22 August 2018

Accepted for publication 8 November 2018

Published 17 December 2018 Volume 2019:11 Pages 13—22

DOI https://doi.org/10.2147/CEOR.S184883

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 3

Editor who approved publication: Professor Samer Hamidi


Zheng-Yi Zhou,1 Wenxi Tang,1 Kathleen F Villa2

1Analysis Group, New York, NY, USA; 2Health Economics and Outcomes Research, Jazz Pharmaceuticals, Palo Alto, CA, USA

Purpose:
The study objective was to develop an economic model to assess projected costs of lost productivity associated with premature deaths due to veno-occlusive disease (VOD)/sinusoidal obstruction syndrome (SOS) with multiorgan dysfunction (MOD) among patients in the US who underwent hematopoietic stem-cell transplant (HSCT) in 2013.
Methods: Data sources included the US Census Bureau and Department of Health, epidemiologic research organizations, and medical research literature. The model considered only lost productivity associated with premature death, with lifetime salary assumed to reflect productivity. Average annual salary was assumed to be the same for HSCT survivors and the general population, with a working age range between 18 and 65 years. Key data inputs included number of HSCTs by graft type (allogeneic and autologous) performed in the US in 2013, HSCT-related mortality, mortality associated with VOD/SOS with MOD, and life-expectancy reduction for HSCT survivors vs the general population. Excess mortality equaled total deaths among patients with VOD/SOS and MOD minus deaths in these patients due to causes other than VOD/SOS with MOD.
Results:
Among 18,284 patients who underwent HSCT in the US in 2013, the model estimated that 361 excess deaths due to VOD/SOS with MOD occurred (158 following allogeneic and 203 after autologous transplants). These deaths accounted for total lost work productivity of 5,990 years and $124,212,173 in lost wages, averaging 17 years and $343,791 per patient. A sensitivity analysis incorporating adjustment factors for epidemiologic and economic inputs calculated total financial loss of $84 million to $194 million.
Limitation: Estimates of post-HSCT VOD/SOS with MOD incidence and mortality were approximated, due to changing HSCT practices.
Conclusion: Premature death due to VOD/SOS with MOD imposes a substantial economic burden in this population in terms of lost productivity. Additional studies of this economic burden are warranted.

Keywords:
veno-occlusive disease/sinusoidal obstruction syndrome, stem-cell transplantation, mortality, lost productivity/income, indirect costs, economic burden

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