TABLE 2.

Potential Effect of More Frequent Molecular Monitoring on HRU Outcomes and Health Care Costs Per Newly Diagnosed CML Patients over First Year of CML Management

	Adjusted Difference in Number of HRU Events/Costs
	Direct Effecta HRU Event	Indirect Effectb HRU Event	Overall Effectc
			HRU Event [95% CI]	Cost, USD 2015 [95% CI]
A. Increasing molecular monitoring frequency from 1 to 2
IP admissions	-0.034	-0.008	-0.04 [-0.08, -0.010]	-$3,175 [-5,438, -677]
IP days	-0.74	-0.13	-0.87 [-1.49, -0.18]
ER visits	-0.06	< -0.01	-0.06 [-0.12, 0.05]	-$50 [-99, 41]
Days with OP services	1.11	-0.13	0.98 [0.25, 1.60]	$307 [80, 501]
Total cost				-$2,918 [-5,213, -349]
B. Increasing molecular monitoring frequency from 2 to 4
IP admissions	-0.057	-0.013	-0.07 [-0.12, -0.02]	-$5,106 [-7,670, -1,312]
IP days	-1.21	-0.19	-1.40 [-2.10, -0.36]
ER visits	-0.10	< -0.01	-0.10 [-0.18, 0.11]	-$87 [-156, 92]
Days with OP services	2.31	-0.26	2.05 [0.52, 3.43]	$640 [162, 1,072]
Total cost				-$4,554 [-7,203, -587]

Note: Regression models were adjusted for the following a priori selected potential confounding factors: age, sex, year of index date, U.S. census region, health plan type, whether patients started TKI therapy on recommended dose for CML-chronic phase, Darkow CML Complexity Index score, and Charlson-Quan Comorbidity Index score.

^aDirect effect of qPCR test frequency on HRU alone.

^bIndirect effect of qPCR test frequency through TKI adherence; increasing qPCR test frequency increased TKI adherence level, which in turn reduced HRU events.

^cSum of direct and indirect effects.

CI = confidence interval; CML = chronic myeloid leukemia; ER = emergency room; HRU = health resource utilization; IP = inpatient; OP = outpatient; qPCR = quantitative real-time polymerase chain reaction; TKI = tyrosine kinase inhibitor; USD = U.S. dollars.