scholarly journals PCN124 REAL-WORLD HEALTHCARE RESOURCE UTILIZATION AND TOTAL COST OF CARE AMONG US MEDICARE PATIENTS WITH CHRONIC LYMPHOCYTIC LEUKEMIA RECEIVING FIRST-LINE IBRUTINIB VS CHEMOIMMUNOTHERAPY

2020 ◽  
Vol 23 ◽  
pp. S44-S45
Author(s):  
Q. Huang ◽  
B. Emond ◽  
M.H. Lafeuille ◽  
D. Gupta ◽  
P. Lefebvre ◽  
...  
2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18696-e18696
Author(s):  
Ali McBride ◽  
Shoshana Daniel ◽  
Maurice T. Driessen ◽  
Agota Szende ◽  
Azhar Choudhry ◽  
...  

e18696 Background: Rituximab is a chimeric anti-CD20 monoclonal antibody therapy, used primarily for treating chronic lymphocytic leukemia (CLL) and non-Hodgkin’s lymphoma (NHL). Rituximab-abbs, the first rituximab biosimilar, was approved in the UK in 2017 and was expected to significantly reduce drug acquisition costs, but there is a lack of real-world evidence regarding patient outcomes with rituximab-abbs. This non-interventional study assessed the real-world effectiveness and tolerability of rituximab-abbs and rituximab in treatment-naive patients with CLL or NHL. Methods: Anonymized data on patient characteristics, response to treatment, healthcare resource utilization and costs were abstracted retrospectively via an online physician survey. UK-registered hematologists and oncologists reported on randomly selected patients aged ³18 years from four cohorts with documented CLL or NHL, who had received rituximab-abbs or rituximab as first-line immunotherapy (between January 1, 2018 and June 30, 2019). Patient outcomes data were provided from first treatment to the last date of follow-up available in the medical records. Results: In total, 46 physicians abstracted data from 201 patient charts. Demographic profiles of the cohorts were similar. For both treatments, the overall response rate (ORR) was very high for patients with CLL or NHL (Table) along with rates for six-month progression-free survival (96–98% across cohorts) and one-year survival (98–100% across cohorts). Most patients did not experience a grade ≥3 adverse event during treatment (54–66% across cohorts); the most common grade ≥3 adverse events were neutropenia, fatigue, anemia and infusion reactions. Healthcare resource utilization was similarly high across cohorts, driven by drug costs, diagnostic testing, oncologist office visits, and day case hospital admissions. Mean annual savings of approximately £1,000 per patient were seen with rituximab-abbs, attributable to first-line treatment costs. Conclusions: The originator (rituximab) and biosimilar (rituximab-abbs) products yielded comparable efficacy and tolerability in treating CLL and NHL in routine UK clinical practice, with rituximab-abbs demonstrating cost-savings. These findings should inform decision-makers on the potential for cost reductions where the biosimilar rituximab-abbs is available as a treatment alternative.[Table: see text]


2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 302-302
Author(s):  
Bruce A. Feinberg ◽  
Brad Schenkel ◽  
Ali McBride ◽  
Lorie Ellis ◽  
Janna Radtchenko

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.


Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 3549-3549
Author(s):  
Debra Irwin ◽  
Lu Zhang ◽  
Kathleen Wilson ◽  
Gerard Hoehn ◽  
Erika Szabo ◽  
...  

Abstract OBJECTIVES: The purpose of this study was to examine real-world differences in healthcare resource utilization of indolent non-Hodgkin's Lymphoma (iNHL) patients treated with first-line ibrutinib monotherapy (IM) or first-line bendamustine + rituximab (BR) combination therapy using U.S. administrative claims data. METHODS: The MarketScan® Research Databases were used to identify patients aged 18 years or older with commercial or Medicare supplemental insurance plans based on their first prescription (index date) of either IM or BR therapy between 02/01/2014 and 08/30/2017. Patients were required to be diagnosed with iNHL and be treatment naïve, as well as be continuously enrolled (CE) for 6 months prior to and at least 30 days following the index date. All-cause and iNHL-related healthcare resource utilization (e.g., inpatient admission (IP) and emergency room (ER) visits) were evaluated during a 12-month follow-up period from the index date among the subset of patients with 12 months of continuous enrollment and reported per-patient per-month (PPPM). Statistical differences in the distribution of IP and ER visits between the IM versus BR therapy groups were estimated using chi-squared test for categorical variables and t-test for continuous variables. RESULTS: A total of 1,544 iNHL patients were identified, with 207 patients in the IM cohort and 1,337 patients in the BR cohort. The IM cohort was significantly older (mean = 68.3 years; SD = 11.8) then the BR cohort (mean age = 62.1 years; SD = 11.1). The proportion of females was significantly (p<.05) lower in the IM cohort (36%) relative to the BR cohort (49%). The two cohorts did not differ in comorbidity as assessed by National Cancer Institute Comorbidity Index score (IM=0.7 vs. BR=0.8, p=0.40). The results of the comparisons between the two groups with 12 months of follow-up (IM = 110; BR = 745) are provided in Table 1. For all-cause healthcare utilization, the proportion of IM patients experiencing at least one IP admission was significantly higher than the BR cohort as were the PPPM number of admissions. The proportion of patients with at least one ER visit was similar in the IM and BR cohorts. However, the average PPPM number of ER visits was significantly higher in the IM cohort relative to the BR cohort. A similar pattern was found for the iNHL-related healthcare utilization variables with one exception. The proportion of patients with at least one iNHL-related ER visit was significantly higher in the IM relative to the BR cohort. Conclusions: The current study examined differences in healthcare utilization among iNHL-patients treated in a front-line setting with either ibrutinib or BR combination therapy. Results indicated that not only did more ibrutinib patients experience an IP admission and ER visits, including both all-cause and iNHL-related, but they also experienced more repeat admissions and ER visits. These real-world findings highlight the importance of considering the healthcare resource utilization of iNHL patients which may be associated with their first-line therapy. Disclosures Irwin: Teva: Consultancy. Zhang:Teva: Consultancy. Wilson:Teva: Consultancy. Hoehn:Teva: Employment. Szabo:Teva: Employment. Tang:Teva: Employment.


Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 3548-3548
Author(s):  
Debra Irwin ◽  
Lu Zhang ◽  
Kathleen Wilson ◽  
Gerard Hoehn ◽  
Erika Szabo ◽  
...  

Abstract OBJECTIVES: The purpose of this study was to examine the real-world differences in healthcare resource utilization in chronic lymphocytic lymphoma (CLL) patients treated with either first-line ibrutinib monotherapy (IM) or first-line bendamustine + rituximab (BR) therapy using U.S. administrative claims data. METHODS: The MarketScan® Research Databases were used to identify patients aged 18 years or older with commercial or Medicare supplemental insurance plans based on their first prescription (index date) of either IM or BR therapy between 02/01/2014 and 08/30/2017. Patients were required to be diagnosed with CLL and be treatment naïve, as well as be continuously enrolled (CE) for 6 months prior to and at least 30 days following the index date. All-cause and CLL-related healthcare resource utilization (e.g., inpatient admission (IP) and emergency room (ER) visits) were evaluated during a 12-month follow-up period from the index date among the subset of patients with 12 months of continuous enrollment and were reported per-patient per-month (PPPM). Statistical differences in the distribution of IP and ER visits between the IM versus BR therapy groups were estimated using chi-squared test for categorical variables and t-test for continuous variables. RESULTS: A total of 1,886 CLL patients were identified, with 1,157 patients in the IM cohort and 729 patients in the BR cohort. The IM cohort was significantly older (mean = 69.3 years; SD = 11.6) then the BR cohort (mean age = 66.4 years; SD = 9.8). There was a similar proportion of females (IM = 36%; BR = 32%), and no significant difference in the National Cancer Institute Comorbidity Index score was observed between the two cohorts (IM=0.9 vs BR=0.8, p=0.34). The results of the comparisons between the two groups with 12 months of follow-up (IM = 589; BR = 436) are provided in Table 1. For all-cause healthcare utilization, the proportion of patients experiencing at least one IP admission and the PPPM number of admissions was significantly higher in the IM cohort compared to the BR cohort. The proportion of patients with at least one ER visit was higher in the IM than in the BR cohort, but the difference was not statistically significant. However, the PPPM number of ER visits was significantly higher in the IM cohort. A similar pattern was found for the CLL-related healthcare utilization variables with two exceptions. First, the average length of stay (ALOS) per CLL-related IP admission was significantly longer for the IM than BR cohort; whereas, ALOS per all-cause IP admission was longer for the IM cohort, but the difference was not significantly different. Second, while patients in the IM cohort experienced more CLL-related ER visits, they were not significantly higher in the IM cohort than in the BR cohort. Conclusions: The current study examined differences in healthcare utilization during a 12 month period among CLL-patients initially treated in a front-line setting with either ibrutinib or BR combination therapy. Results indicated that not only did more ibrutinib patients experience an IP admission and ER visits, both all-cause and CLL-related, but they also experienced more repeat admissions and ER visits. These real-world findings highlight the importance of considering the healthcare resource utilization of CLL patients which may be associated with their first-line therapy. Disclosures Irwin: Teva: Consultancy. Zhang:Teva: Consultancy. Wilson:Teva: Consultancy. Hoehn:Teva: Employment. Szabo:Teva: Employment. Tang:Teva: Employment.


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