Abstract
Using a retrospective claims database, we estimated the economic costs of progression among patients with follicular non-Hodgkin lymphoma (f-NHL) treated in an outpatient community-based setting. Patients with f-NHL who received care between 1 July 2006 and 31 December 2009 were categorized into two cohorts based on whether they experienced progressive disease (PD) or not. Costs per patient per month (PPPM) were compared between patients with PD versus non-PD. Follow-up time was censored at the last entry for disease status or 6 months after the date of remission/stable disease or progression. Of the 1002 patients with f-NHL identified, 268 progressed and 734 did not. The mean overall costs PPPM over the 6-month follow-up period were significantly higher for patients with PD versus non-PD ($3527 vs. $860; difference = $2667; p < 0.001). This cost difference persisted within all resource categories evaluated. Results of this study indicate that therapies which delay progression for patients with f-NHL may result in potential cost savings.
Highlights
Follicular non-Hodgkin lymphoma (f-NHL) is a slow-growing subtype of NHL that constitutes approximately 20–25% of all NHL and 70% of indolent lymphomas [1]
Consolidation therapy with rituximab followed by 90Y-ibritumomab tiuxetan in patients with f-NHL who achieved complete or partial response after first-line induction therapy prolonged progression-free survival (PFS) [13]
Data presented from a large international phase III trial demonstrated that patients with advanced f-NHL treated with rituximab maintenance had a 50% reduction in risk of progressive disease (PD) relative to patients who did not receive rituximab maintenance [20,21]
Summary
Follicular non-Hodgkin lymphoma (f-NHL) is a slow-growing (indolent) subtype of NHL that constitutes approximately 20–25% of all NHL and 70% of indolent lymphomas [1]. The natural history of f-NHL is characterized by continuous risk of relapse and progression, with each event becoming less sensitive to treatment and each remission shorter than the preceding one [5,6]. This makes disease management challenging, with a wide array of treatment options ranging from watchful waiting to intensive therapies that are typically aimed at delaying disease relapse and progression with fewest adverse effects. Maintenance rituximab was beneficial in patients with f-NHL who achieved a partial or complete remission after initial single-agent first-line rituximab therapy [16,17]. Data presented from a large international phase III trial demonstrated that patients with advanced f-NHL treated with rituximab maintenance had a 50% reduction in risk of progressive disease (PD) relative to patients who did not receive rituximab maintenance [20,21]
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