Abstract
IntroductionThere are limited data on treatment patterns, adverse events (AEs), and economic burden in younger, commercially insured patients treated for mantle cell lymphoma (MCL).MethodsAdults with ≥1 treatment for MCL between 1 November 2013‐31 December 2017 were identified from IQVIA Real‐World Data Adjudicated Claims‐US; index date was first treatment. Patients carried ≥1 MCL diagnosis, were newly treated, and were enrolled continuously for ≥12 months prior to and ≥30 days following index. Patients receiving the four most common MCL regimens were included. Measures included frequency of incident AEs, resource use, and costs overall and by number of AEs. Adjusted logistic regression and generalized linear modeling evaluated risk of hospitalization and all‐cause costs per patient per month (PPPM).ResultsTwo thousand five hundred and nine treated patients had a drug‐specific code and were classified to a specific treatment regimen. Of those patients, 1785 patients received at least one of the four most commonly used MCL regimens (R‐CHOP, rituximab monotherapy, B‐R, and ibrutinib) at some point over follow‐up (median 23 months). R‐CHOP was the most common regimen observed in the first line (26%), followed by rituximab monotherapy (19%), B‐R (15%), and ibrutinib (5%). The median age was 57 years; median Charlson Comorbidity Index was 0. Among patients receiving the four most common regimens, 63% of patients experienced ≥1 incident AE (R‐CHOP 77%, B‐R 58%, and ibrutinib 52%). An increasing number of incident AEs was associated with increased hospitalization risk (odds ratio = 2.4; 95% Confidence Interval [CI] 2.1‐2.7) and increased mean costs PPPM (cost ratio = 1.1; 95% CI 1.1‐1.2).DiscussionThis is the largest study describing treatment patterns and clinical and economic impact of MCL treatment. The most common regimens were R‐CHOP, rituximab monotherapy, B‐R, and ibrutinib. The majority of treated patients experienced at least one incident AE, with hospitalization risk and all‐cause costs increasing as the number of AEs increased.
Highlights
There are limited data on treatment patterns, adverse events (AEs), and economic burden in younger, commercially insured patients treated for mantle cell lymphoma (MCL)
This study describes the most common MCL treatments and associated toxicities, healthcare resource use (HRU) and costs in the largest sample of treated MCL patients to date
Patients in our study were younger than the general MCL population in the United States (US), reflecting the commercially insured population in the database we used
Summary
Mantle cell lymphoma (MCL) is a rare, often aggressive B‐ cell non‐Hodgkin's lymphoma (NHL), with a median age at diagnosis of 68.1 MCL accounts for 3% of all newly diagnosed NHL cases in the United States (US) with approximately 3300 new cases diagnosed in the US each year.[2]. | 7175 visits per patient in the 12 months after initiation of therapy versus the 12 months prior to treatment initiation (mean ED visits 0.5 before treatment vs 0.8 after treatment; mean outpatient visits 31 before treatment vs 63 after treatment).[17] Another retrospective study reported that the mean monthly total healthcare cost increased from $1303 per patient during the 12 months before MCL diagnosis to $10964 after diagnosis; HRU and costs were higher among patients experiencing adverse events (AEs).[16]. Further evidence on the burden of novel and conventional therapies for MCL is crucial to patients and healthcare decision makers to guide treatment decisions The purpose of this retrospective observational cohort study was to describe current treatment patterns, treatment‐related toxicity, and HRU and costs in a large, contemporary cohort of treated patients with MCL
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