Mantle Cell Lymphoma Costs Vary by Treatment Type, Adverse Events
The treatment of mantle cell lymphoma (MCL) carries a significant economic burden in the real-world setting, according to research presented at the 59th American Society of Hematology Annual Meeting & Exposition (December 9-12, 2017; Atlanta, GA).
Drivers of costs—which varied by treatment type—included inpatient admissions, office visits, prescription drugs, and treatment related to adverse events.
Few studies have addressed costs and health care resource utilization (HRU) among patients with MCL, an aggressive subtype with a poor prognosis. Moderate to severe adverse events associated with MCL often influence treatment adherence, and may increase HRU and costs due to medical attention.
Sudeep Karve, PhD, AstraZeneca (Wilmington, MA), and colleagues sought to determine costs and HCU associated with MCL, as well as to determine how cost variations are affected by treatment type. They further observed the economic impact of adverse events in this population.
Researchers retrospectively identified 783 patients (median age, 65 years; range, 19-99) treated for MCL between 2010 and 2015. The mean monthly cost for all-cause treatment was $8393 (standard deviation [SD], $16,276), with MCL-related costs were $6730 (SD, $14,779). The main drivers of all-cause costs were inpatient admissions (mean, $4817; SD, $14,267) and office visits (mean, $1493; SD, $3250).
The highest mean monthly costs by treatment type were seen by patients receiving rituximab/cyclophosphamide/doxorubicin/vincristine (R-CHOP) chemotherapy, followed by ibrutinib monotherapy, bendamustine and rituximab, and rituximab monotherapy. Patients treated with ibrutinib had the highest prescription drug costs (mean, $14,038; SD, $21,936).
The mean length of stay for admitted patients was 3 days (range, 2-4) among patients without adverse events, which rose to 5.2 days (range, 1-50) among patients who reported six or more adverse events.
Patients reporting adverse events had a twofold increase in mean all-cause monthly costs (mean, $10,335; SD, $16,868) when compared with patients with no adverse events (mean, $4298; SD, $10,082).—Cameron Kelsall