Abstract
We conducted an analysis of indirect costs alongside the LY.12 randomized trial in patients with relapsed or refractory (R/R) aggressive non-Hodgkin lymphoma (NHL). Lost productivity data for Canadian patients and caregivers in the trial were collected at baseline and with each chemotherapy cycle pre-transplant, using an adapted Lost Productivity questionnaire. Mean per patient indirect costs were CAD 2999 for patients in the GDP arm and CAD 3400 in the DHAP arm. A substantial majority was not working or had to reduce their workload during this treatment time. Salvage chemotherapy for R/R aggressive NHL is associated with significant indirect costs to patients and their caregivers.
Highlights
Oncol. 2021, 28, 1256–1261. https://Aggressive lymphomas are curable cancers at presentation, but 20–30% of patients will experience progression
The CCTG LY12 trial demonstrated that, in relapsed/refractory aggressive lymphoma patients, GDP was non-inferior to DHAP with respect to responses pre-autologous stem cell transplantation (ASCT), but it is associated with less toxicity, improved quality of life, and dominance when it comes to direct costs and quality-adjusted outcomes [4]
In this follow-up work, we demonstrated that salvage chemotherapy for R/R aggressive Non-Hodgkin lymphomas (NHL) is overall associated with substantial indirect costs to the patients and their caregivers, with a majority not working or having to reduce their workload during this treatment time
Summary
Aggressive lymphomas are curable cancers at presentation, but 20–30% of patients will experience progression For such patients, salvage chemotherapy followed by autologous stem cell transplantation (ASCT) remains one of the only curative options [1]. Salvage chemotherapy followed by autologous stem cell transplantation (ASCT) remains one of the only curative options [1] This is a disease mostly affecting older patients, about 45% of patients are diagnosed between the ages of 20 and 64, which for most is during their productive working years. A recent study examined the indirect costs and lost productivity associated with NHL in commercially insured working adults in the US, using a large commercial insurance claims database, and linking this to clinical diagnoses and outcomes [2]. When comparing 168 NHL patients to 508 controls and adjusting for relevant variables, NHL patients incurred significantly more estimated mean days of workplace productivity loss (31.99 days, p < 0.001) and significantly more estimated mean indirect costs (CAD 6302.34; 95% CI: CAD 4973.40, CAD 7631.28; p < 0.001)
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