Improved research and diagnostics could help reduce the economic burden of blood disorders

Since the arrival of personalized healthcare and molecular diagnostics, there has been growing support for utilizing DNA, RNA, and protein-based biomarker detection methods as a means to help reduce rising healthcare costs (1). Molecular diagnostics can help select the right patients for the right treatments, and define which patients require costly confirmatory diagnostic tests. In doing so, it may help reduce the extreme financial burden of healthcare costs.

The European Hematology Association (EHA), the leading European society for the medical discipline concerned with blood and blood-forming organs, funded two recently published studies (2, 3) which analyze the economic burden of blood disorders across the European Union (EU), Iceland, Norway and Switzerland. Without considering the enormous physical and emotional costs to those affected and their relatives, the studies find that financial costs related to both malignant and non-malignant blood disorders in these areas amount to €23 billion per year. Blood disorders represent many diseases including anemias, coagulation disorders (e.g. thrombosis), bleeding disorders (e.g. hemophilia) and malignant blood cancers (e.g. leukemia, multiple myeloma, lymphoma). In Europe, blood disorders affect around 80 million people, and annually, lead to about 110,000 deaths (13). With respect to blood cancers, the statistics are also staggering: in the US, someone is diagnosed with a blood cancer every 3 minutes (4), in the UK every 20 minutes (5) and in Germany, every 15 minutes (6).

In the EHA-funded studies, the cost of blood disorders was broken down into healthcare expenditure (€15.6 billion), productivity loss due to illness and mortality (€5.6 billion) and the costs of informal care (€1.6 billion). The latter amount is based on hours of unpaid care provided by relatives to people suffering from blood disorders. Of the €15.6 billion in healthcare costs, 28% pertains to medications (€4.3 billion) and 48% to inpatient care (€7 billion). Malignant and non-malignant blood disorders account for a similar proportion of overall economic burden associated with all blood disorders. In terms of total cancer costs in the EU (€143 billion), malignant blood disorders contribute to 8% (€12 billion), making blood cancers the 4th most expensive behind lung (15%), breast (12%) and colorectal (10%) cancers. When considering healthcare costs only, malignant blood disorders account for 12%, behind breast cancer (13%) and ahead of colorectal and prostate cancers (11% each). These data will help policy makers in their decision-making with regard to future healthcare and research budgets. This analysis stresses the need for additional funding of translational and clinical research, which is fundamental to all aspects of hematology.

The expectation is that the economic burden of blood disorders will rise in the coming years due to an increase in the aging population which requires more health care, as well as higher prices for new drug treatments (7). These are the very reasons that five years ago the economic burden of cancer in the US was also projected to grow (8). A 2013 study (9) corroborates the major economic burden of cancers globally, using chronic myeloid leukemia (CML) as an example of the extreme cost of cancer therapies. This study demonstrates how cancer treatment costs widely vary among geographical regions, and are extremely high in the US. For example, the annual price for the CML approved drugs imatinib, nilotinib and dasatinib in the US is rounded to $92 K, $115.5 K and $123.5 K respectively. These CML treatment costs are 70%, 92% and 37% higher (respectively) in the US than in Germany. The prices for therapeutics in Germany may directly or indirectly influence the price for the same treatments in 31 countries (11) and the prices for new drugs here are negotiated according to their benefit compared to other drugs on the market for the same indication (10).

To counteract this trend, a more advanced understanding of blood disorders, in particular cancer-related ones, is needed, along with more effective treatment plans and improved diagnostics (2, 3). Diagnosing the right disease early on could potentially lead to significant reduction in healthcare costs (12). According to the Office of Health Economics (OHE) the full value that well-validated diagnostics can contribute to healthcare is underappreciated in healthcare systems around the world (14). Molecular diagnostics can deliver valuable cost savings by providing additional information to support healthcare decisions that reduce uncertainty about the consequences of care choices. Improved stratification of patients enabled by molecular diagnostics may also imply organizational and managerial gains in patient access and allocation to meet unmet needs (15).

To this end, QIAGEN’s ipsogen portfolio offers an expanding menu of reliable solutions for improved translational research and molecular diagnostics for oncology, including hematological cancers. For specific diagnosis of myeloproliferative neoplasms (MPN) the ipsogen JAK2 RGQ PCR Kit (available for in vitro diagnostic (IVD) use only in Europe) can be used for quick and precise quantification of the JAK2 V617F mutation. The ipsogen CALR RGQ PCR Kit, which will be available in both CE-IVD and research use only (RUO) versions later this year, can be used in the same workflow as the ipsogen JAK2 RGQ PCR kit for detection of both JAK2 V617F and CALR exon 9 mutations from the same blood sample. For patient monitoring of chronic myeloid leukemia (CML), the International Scale (IS)-standardized ipsogen BCR-ABL1 Mbcr RGQ RT-PCR Kit (available for IVD use only in Europe) offers a highly sensitive kit for the quantification of even low amounts of BCR-ABL1 Mbcr to effectively monitor patient treatment response, reporting to MR5. Find out more about the broad ipsogen portfolio of oncohematology biomarker solutions available for research use only in the US and products available in Europe.

References:

  1. 1. Jakka, S. and Rossbach, M. (2013) An economic perspective on personalized medicine. The HUGO Journal 7:1. Link
  2. 2. Burns, R., et al. (2016). Economic burden of malignant blood disorders across Europe: a population-based cost analysis. Lancet Haematol 3(8): e362–e370. Link
  3. 3. Luengo-Fernandez, R., et al. (2016) Economic burden of non-malignant blood disorders across Europe: a population-based cost analysis. Lancet Haematol 3(8): e371–e378. Link
    4. Leukemia and Lymphoma Society (LLS) webpage: http://www.lls.org/facts-and-statistics/facts-and-statistics-overview
  4. 5. DKMS Delete blood cancer UK webpage: https://www.deletebloodcancer.org.uk/en
  5. 6. DKMS Delete blood cancer Germany webpage: https://www.dkms.de/en/basic-information
  6. 7. Green, T., et al. (2016) Costs of haematological disease high and rising. Lancet Haematol 3(8):e353-354. Link
  7. 8. Yabroff, K.R., et al. (2011) Economic Burden of Cancer in the US: Estimates, Projections, and Future Research. Cancer Epidemiol Biomarkers Prev. 20(10): 2006–2014. Link
  8. 9. Abboud, C. et al. (2013) The price of drugs for chronic myeloid leukemia (CML) is a reflection of the unsustainable prices of cancer drugs: from the perspective of a large group of CML experts. Blood 121(22):4439–4442. Link
  9. 10. Bundesministerium für Gesundheit. The act on the reform on the market for medicinal products (Gesetz zur Neuordnung des Arzneimittelmarktes (AMNOG). Link
  10. 11. The Pharma Letter. German pharma criticizes new AMNOG vetting procedure. March 2012. Link
  11. 12. Etzioni, R., et al. (2013) The case for early detection. Nature Reviews Cancer 3: 243–252. Link
  12. 13. EHA press release: Economic Burden of Blood Disorders in EU is €23 billion Link
  13. 14. Garrison, L., Mestre-Ferrandiz, J., and Zamora, B. (2016) The Value of Knowing and Knowing the Value: Improving the Health Technology Assessment of Complementary Diagnostics. White paper from The Office of Health Economics 1–31. Link
  14. 15. Garau, M., et al. (2013) Can and should value based pricing be applied to molecular diagnostics? Personalized Medicine 10(1) 61-72. Link
Kathryn Collinet

Kathryn Collinet, PhD, is a Technical and Marketing Writer for Personalized Healthcare and Oncology at QIAGEN. She trained as a molecular biologist at the University of Barcelona and the Institute for Research in Biomedicine, where she studied DNA and protein modifications and their influence on chromatin conformation and gene expression. Since 2011 Kathryn has been working in marketing communications for the scientific information and molecular diagnostics industries. Kathryn has a passion for delivering knowledge and insights about molecular and clinical technologies, and their power to impact research and healthcare.

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