Evaluation of health care resource utilization (HRU) in real-world patients treated for chronic lymphocytic leukemia (CLL).

Abstract

302 Background: Elucidating healthcare resource utilization (HRU) in real-world clinical practice is essential in understanding the economic burden of a disease. The objective of this study was to evaluate HRU in treated CLL patients. Methods: Using proprietary MORE Registry Research Edition claims, patients treated with antineoplastics for CLL identified by ICD-9 codes during a 48-month period (August 2009-2013) were selected. Patients who were pregnant or <18 years of age, or were treated for secondary malignancies were excluded. Descriptive statistics were used to analyze HRU primarily focused on hospitalizations, office visits, and emergency room (ER) visits. Chi-square tests were used to compare HRU rates by age group (<65 and ≥65); t-tests were used to compare means. Results: Of 2,013 CLL patients, median age was 72 years, 78% were ≥65 years of age, 61% were male, 67% Medicare, and 34% were treated in the relapsed setting. The mean comorbidity index was significantly higher in the ≥65 age group compared to the <65 age group (2.2 vs. 1.3, p<0.001). Overall, 97% of patients had an office visit, 31% had a hospitalization, and 34% had an ER visit. There were no statistically significant differences in HRU between age groups, although rates trended higher in the older group: office visits 97% vs. 96%, hospitalizations 32% vs. 29%, and ER visits 34% vs. 32%. Mean hospital length of stay (LOS) was 5.7 days and trended higher in the ≥65 age group (5.8 vs. 5.4 days), but the difference was not statistically significant. Conclusions: Healthcare resource utilization was considerable among patients treated for chronic lymphocytic leukemia. Approximately one-third of patients were hospitalized, and one-third experienced an emergency room visit. Despite a higher mean comorbidity index in the ≥65 age group, HRU was not significantly higher in the older group. Further evaluation of HRU among CLL patients by line of therapy, age, comorbidity index, and payer type is warranted.