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Study: Medicare pays average of $185K per patient to treat multiple myeloma

While inpatient and outpatient care drive the cost for diagnosis and treatment of multiple myeloma, prescription drugs are the main drivers of cost for continuing care, according to new research. Photo by TBIT/Pixabay
While inpatient and outpatient care drive the cost for diagnosis and treatment of multiple myeloma, prescription drugs are the main drivers of cost for continuing care, according to new research. Photo by TBIT/Pixabay

July 9 (UPI) -- Medicare beneficiaries with multiple myeloma incur an average of nearly $185,000 in costs billed to the government-run plan for their diagnosis and treatment, according to an analysis published Friday by JAMA Network Open.

This figure includes roughly $1,200 in annual costs, initially, for screening and diagnosis, as well as more than $11,000 per year in charges for treatment, the data showed.

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Medicare is billed, on average, roughly $5,700 annually per patient for "continuing care" for older adults with multiple myeloma who respond to treatment, while it is charged nearly $6,300 per patient per year for those whose disease is terminal.

"We found inpatient and outpatient costs to be major drivers of costs in the pre-diagnosis, initial and terminal care phases for multiple myeloma patients," study co-author Kaustuv Bhattacharya told UPI in an email.

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"However, for the continuing care phase, which typically involves costs for lower-intensity maintenance therapy, prescription drugs were the major cost drivers [and] this was potentially due to long-term use of expensive immunotherapy drugs," said Bhattacharya, an assistant professor of pharmacy administration at the University of Mississippi in Oxford.

Multiple myeloma, or cancer that occurs in white blood cells, accounts for less than 2% of all cancers diagnosed in the United States, according to the American Cancer Society.

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However, it is among the most difficult -- and expensive -- cancers to treat, due in large part to the need for intensive chemotherapy and radiation, as well as long-term drug therapy.

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Older adults, particularly those age 65 and above, or the population covered by Medicare, are considered to be at increased risk for the disease, researchers said.

For this study, the researchers reviewed Medicare claims data for 4,533 beneficiaries diagnosed with and treated for multiple myeloma between 2006 and 2016 and compared them with claims data for non-cancer beneficiaries.

The average age of the study participants was roughly 76.

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Lifetime costs for those with multiple myeloma averaged just under $184,500, although these charges included only those billed to Medicare and not any out-of-pocket expenses.

Inpatient and outpatient care charges were the "major cost drivers" for the diagnosis and treatment of the disease, accounting for 40% to 50% of fees billed to Medicare, the data showed.

However, at 45%, prescription drugs were the largest cost drivers during patients' continuing care, the researchers said.

"Our study estimated the cost burden of multiple myeloma from Medicare's perspective over the disease lifetime," Bhattacharya said.

"This information can potentially help patients undergoing treatment for myeloma and providers to better understand the financial burden of the disease across the different phases of care continuum," he said.

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