Real-world treatment patterns, costs, and outcomes in patients with AL amyloidosis: analysis of the Optum EHR and commercial claims databases

Angela Dispenzieri, Jeffrey Zonder, James Hoffman, Sandra W. Wong, Michaela Liedtke, Rafat Abonour, Anita D’Souza, Charlene Lee, Sarah Cote, Ravi Potluri, Eric Ammann, Nam Phuong Tran, Annette Lam, Sandhya Nair

Research output: Contribution to journalArticlepeer-review

Abstract

Background: This study characterised real-world treatment patterns, clinical outcomes, and cost-of-illness in patients with light-chain (AL) amyloidosis. Methods: Data were extracted from the US-based Optum® EHR and Clinformatics® Data Mart (claims) databases (2008–2019) for patients newly diagnosed with AL amyloidosis and who initiated anti-plasma cell therapies. Healthcare resource utilisation (HCRU) and related costs were compared across lines of therapy (LOT). Incidences of cardiac and renal failure were evaluated using the Kaplan-Meier method. Results: About 1347 patients (EHR, n = 776; claims, n = 571) were included. Median age was 68 years; 56.8% were male. At initial diagnosis, 33.1% and 15.1% of patients had cardiac and renal failure, respectively. Most patients received bortezomib-containing treatment in LOT1 (69%); bortezomib-cyclophosphamide-dexamethasone was most common (26%). HCRU was similar across LOTs. Mean per-patient-per-month and per-patient-per-LOT costs were $19,343 and $105,944 for LOT1, $19,183 and $95,793 for LOT2, and $16,611 and $128,446 for LOT3, respectively. Costs were primarily driven by anti-plasma cell therapies, outpatient visits, and hospitalisations. The 5-year cardiac and renal failure rates following initial diagnosis were 64.5% and 39.0%, respectively. Conclusion: AL amyloidosis is associated with substantial costs and suboptimal outcomes, highlighting the need for new therapeutic approaches to prevent organ deterioration, and reduce disease burden.

Original languageEnglish (US)
JournalAmyloid
DOIs
StateAccepted/In press - 2022

Keywords

  • AL amyloidosis
  • burden of illness
  • optum claims
  • optum EHR
  • Real-world treatment patterns

ASJC Scopus subject areas

  • Internal Medicine

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