Treatment Patterns and Health Care Costs in Commercially Insured Patients with Follicular Lymphoma.

Nathan Fowler,Stephanie Manson,Frank Li,Qiufei Ma,Guifang Chen,Stephen Lim

doi:10.36469/jheor.2020.16784

Abstract

BackgroundFew studies have estimated the real-world economic burden such as all-cause and follicular lymphoma (FL)-related costs and health care resource utilization (HCRU) in patients with FL.ObjectivesThis study evaluated outcomes in patients who were newly initiated with FL indicated regimens by line of therapy with real-world data.MethodsA retrospective study was conducted among patients with FL from MarketScan® databases between January 1, 2010 and December 31, 2013. Patients were selected if they were ≥18 years old when initiated on a FL indicated therapy, had at least 1 FL-related diagnosis, ≥1 FL commonly prescribed systemic anti-cancer therapy after diagnosis, and did not use any FL indicated regimen in the 24 months prior to the first agent. These patients were followed up at least 48 months and the outcomes, including the distribution of regimens by line of therapy, the treatment duration by line of therapy, all-cause and FL-related costs, and HCRU by line of therapy were evaluated.ResultsThis study identified 598 patients who initiated FL indicated treatment. The average follow-up time was approximately 5.7 years. Of these patients, 50.2% (n=300) were female, with a mean age of 60.7 years (SD=13.1 years) when initiating their treatment with FL indicated regimens. Overall, 598 (100%) patients received first-line therapy, 180 (43.6%) received second-line therapy, 51 received third-line therapy, 21 received fourth-line therapy, and 10 received fifth-line therapy. Duration of treatment by each line of therapy was 370 days, 392 days, 162 days, 148 days, and 88 days, respectively. The most common first-line regimens received by patients were rituximab (n=201, 33.6%), R-CHOP (combination of rituximab, cyclophosphamide, doxorubicin hydrochloride [hydroxydaunomycin]; n=143, 24.0%), BR (combination of bendamustine and rituximab; n=143, 24.0%), and R-CVP (combination of rituximab, cyclophosphamide, vincristine, and prednisone; n=71, 11.9%). The most common second-line treatment regimens were (N=180): rituximab (n=78, 43.3%) and BR (n=41, 22.8%). Annualized all-cause health care costs per patient ranged from US$97 141 (SD: US$144 730) for first-line to US$424 758 (SD: US$715 028) for fifth-line therapy.ConclusionsThe primary regimens used across treatment lines conform to those recommended by the National Comprehensive Cancer Network clinical practice guidelines. The economic burden for patients with FL is high and grows with subsequent lines of therapy.

Highlights

The most common first-line regimens received by patients were rituximab (n=201, 33.6%), R-CHOP, bendamustine plus rituximab (BR), and rituximab to cyclophosphamide (R-CVP)
The primary regimens used across treatment lines conform to those recommended by the National Comprehensive Cancer Network clinical practice guidelines
These secondary databases are fully compliant with the Health Insurance Portability and Accountability Act of 1996.42,43 This study was designed, implemented, and reported in accordance with the Guidelines for Good Pharmacoepidemiology Practices of the International Society for Pharmacoepidemiology (2016),[44] the Strengthening the Reporting of Observational Studies in Epidemiology guidelines,[45] and with the ethical principles contained in the Declaration of Helsinki.[46]

Summary

Introduction

Of NHL cases.[1,2,3,4] In the United States, FL has an estimated incidence of 3 to 4 per 100 000 people and accounts for approximately 35% of NHLs.[1,5,6] In the United States, the estimated number of new cases in 2016 was 13 960.5 Recent evidence indicates that about 30% to 50% of patients will relapse within 5 years of initial diagnosis.[7,8] The. of NHL cases.[1,2,3,4] In the United States, FL has an estimated incidence of 3 to 4 per 100 000 people and accounts for approximately 35% of NHLs.[1,5,6] In the United States, the estimated number of new cases in 2016 was 13 960.5 Recent evidence indicates that about 30% to 50% of patients will relapse within 5 years of initial diagnosis.[7,8] The View this license’s legal deed at http://creativecommons.org/licenses/by/4.0 and legal code at http://creativecommons.org/licenses/by/4.0/legalcode for more information. Few studies have estimated the real-world economic burden such as all-cause and follicular lymphoma (FL)-related costs and health care resource utilization (HCRU) in patients with FL

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Conclusion