scholarly journals Real-World Healthcare Resource Utilization in Patients with Chronic Lymphocytic Lymphoma: Differences between Patients Treated with Ibrutinib or Bendamustine + Rituximab

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 3548-3548
Author(s):  
Debra Irwin ◽  
Lu Zhang ◽  
Kathleen Wilson ◽  
Gerard Hoehn ◽  
Erika Szabo ◽  
...  
Keyword(s):  
Healthcare Utilization ◽  
Resource Utilization ◽  
Real World ◽  
Index Date ◽  
Healthcare Resource ◽  
Healthcare Resource Utilization ◽  
Similar Proportion ◽  
First Line ◽  
The Difference

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.

scholarly journals Real-World Healthcare Resource Utilization in Patients with Indolent Non-Hodgkin's Lymphoma: Differences between Patients Treated First-Line with Ibrutinib or Bendamustine + Rituximab

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 3549-3549
Author(s):  
Debra Irwin ◽  
Lu Zhang ◽  
Kathleen Wilson ◽  
Gerard Hoehn ◽  
Erika Szabo ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Healthcare Utilization ◽  
Resource Utilization ◽  
Real World ◽  
Index Date ◽  
Healthcare Resource ◽  
Healthcare Resource Utilization ◽  
Hodgkin's Lymphoma ◽  
First Line

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.

Positive subjective measures in abuse liability studies and real-world nonmedical use: Potential impact of abuse-deterrent opioids on rates of nonmedical use and associated healthcare costs

2015 ◽  
Vol 11 (3) ◽  
pp. 199 ◽  
Author(s):  
Alan G. White, PhD ◽  
Joseph LeCates, PhD ◽  
Howard G. Birnbaum, PhD ◽  
Wendy Cheng, MPH, MPhil ◽  
Carl L. Roland, PharmD, MS ◽  
...  
Keyword(s):  
Healthcare Utilization ◽  
Resource Utilization ◽  
Real World ◽  
Healthcare Resource ◽  
Healthcare Resource Utilization ◽  
Abuse Liability ◽  
Subjective Measures ◽  
Nonmedical Use ◽  
Potential Impact ◽  
Drug Liking

Objective: To quantify the potential impact of reductions in positive subjective measures from human abuse liability studies on real-world rates of nonmedical use of prescription drugs and associated healthcare resource utilization and costs.Design: Positive subjective endpoints “overall drug liking,” in-the-moment “drug liking,” and “drug high” Emaxs (peak effects) were recorded from published studies. Nonmedical use data were obtained from the 2010 National Survey on Drug Use and Health (NSDUH) and Drug Abuse Warning Network surveys. Multivariate regressions evaluated the association between the positive subjective endpoints and nonmedical use rates, controlling for prescription volume, whether the drug is an opioid, and controlled substance schedule. A published budget-impact model was used to assess healthcare resource utilization and cost impacts of abuse-deterrent opioid formulations.Results: A five-point reduction in overall drug liking/drug liking/drug high Emax was associated with a 0.25/0.10/0.05 (standard errors: 0.11/0.12/0.07) percentage point decrease in the NSDUH lifetime nonmedical use rates. Those decreases yielded a 11.3/4.2/2.1 percent reduction compared to the samples’ lifetime nonmedical use rates of 2.21/2.38/2.36 percent. On the basis of a number of assumptions, these reductions were associated with private payer cost reductions for a morphine and oxycodone abuse-deterrent formulation in the ranges of $147.9-324.1 million and $230.7-958.7 million, respectively.Conclusions: Reductions in overall drug liking were significantly associated with reduced real-world nonmedical use, healthcare utilization, and costs. Associations using drug high and drug liking were directionally consistent with this finding though not statistically significant. A reduction in positive subjective measures associated with an abuse-deterrent formulation has potential to reduce abuse and associated healthcare utilization and costs.

Treatment adherence, healthcare resource utilization, and costs in patients with gastrointestinal neuroendocrine tumors (GI NETs).

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 337-337 ◽  
Author(s):  
Beilei Cai ◽  
Michael Broder ◽  
Eunice Chang ◽  
Jessie Tingjian Yan ◽  
Al Bowen Benson
Keyword(s):  
Treatment Adherence ◽  
Resource Utilization ◽  
Index Date ◽  
Healthcare Resource ◽  
Healthcare Resource Utilization ◽  
First Year ◽  
Office Visits ◽  
Second Year ◽  
Pharmacologic Treatments

337 Background: This study aimed to assess treatment adherence, healthcare resource utilization and costs in patients with GI NETs who initiated pharmacologic treatments. Methods: In 2 US commercial claims databases, patients ≥18 years with ≥1 inpatient or ≥2 outpatient claims for GI NETs were identified. The first claim for pharmacologic treatments (e.g. somatostatin analogues [SSAs], cytotoxic chemotherapy [CC], targeted therapy) following diagnosis and between 7/1/2009 and 12/31/2013 was defined as the index date. A 6-month clean period before index date and a 6-month pre- and a ≥1-year post-index enrollment were required. Proportion of days covered (PDC) was calculated during the follow up period. Outcomes were reported separately for patients with 1 and 2 years of post-index enrollment. Descriptive statistics including means, standard deviations, and frequencies and percentages for continuous and categorical data, respectively, were reported. Results: Of 1,322 patients with 1-year of follow-up, 847 initiated SSAs, 397 CC, 35 targeted therapies, 2 interferon, and 41 various combinations. Due to sample sizes, remaining results focus only on SSAs and CC. Mean PDC (SD) was 0.669 (0.331) for SSAs and 0.466 (0.236) for CC; SSA users had 20.5 (13.5) office visits and 0.59 (1.03) hospitalizations, CC users had 30.5 (19.8) and 0.89 (1.45) office visits and hospitalizations respectively; total annual cost for SSA-treated patients during the 1st year was $99,691 (82,423) and $134,912 (116,078) for CC. Among 685 patients with 2 years of follow-up, the annual mean costs in the second year were $8,071 and $58,944 lower than the first year for SSAs and CC, respectively. Conclusions: In this descriptive non-comparative study, we reported the resource utilization and costs associated with different treatment therapies. Overall, costs were higher in the first year than in the second year. This 2-database study offers new information on the magnitude and trends in the cost of pharmacologically treated GI NETs. Additional research with a larger sample size would be needed to better understand real-world utilization and costs for GI NET patients treated with different pharmacological therapies.

scholarly journals Healthcare Resource Utilization and Costs Associated with Obinutuzumab Plus Bendamustine Versus Rituximab Plus Bendamustine for First-Line Treatment of Follicular Lymphoma

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 3004-3004
Author(s):  
Tu My To ◽  
Jamie T. Ta ◽  
Arpamas Seetasith ◽  
Rongrong Wang ◽  
Dominic Lai ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Follicular Lymphoma ◽  
Real World ◽  
Index Date ◽  
Healthcare Resource ◽  
Phase Iii ◽  
Publicly Traded ◽  
First Line ◽  
The Past

Abstract Background: Obinutuzumab (G) is an anti-CD20 monoclonal antibody approved in the US for the first-line (1L) treatment of follicular lymphoma (FL), relapsed or refractory FL, and 1L chronic lymphocytic leukemia. G plus chemotherapy (G-chemo) demonstrated superior progression-free survival versus (vs) rituximab (R) plus chemotherapy (R-chemo) in patients with previously untreated FL in the Phase III, randomized GALLIUM study (NCT01332968; Marcus et al. N Engl J Med 2017). R-bendamustine (R-benda) and G-bendamustine (G-benda) are among the most commonly used chemoimmunotherapy (CIT) regimens for FL (Ta et al. J Clin Oncol 2021), and information on comparative healthcare resource use (HRU) and real-world costs associated with G-chemo vs R-chemo in previously untreated FL patients is limited. The aim of this study was to compare HRU and costs for G-benda and R-benda for the 1L treatment of FL using US claims databases. Methods: This was a retrospective cohort study using administrative claims data from the IQVIA PharMetrics® Plus and IBM® MarketScan Commercial and Medicare Supplemental databases. We identified patients aged ≥18 years, who had ≥1 inpatient claim or ≥2 outpatient claims with a diagnosis of FL from February 1, 2015 to September 30, 2020, and received 1L R-benda or G-benda between February 1, 2016 and March 31, 2020. The first claim for FL treatment was the index date. All patients had ≥12 months of pre- and ≥6 months of post-index continuous enrollment in medical and pharmacy benefits. Patients with other primary cancers, FL treatment, diffuse large B-cell lymphoma (DLBCL), or stem cell transplant during the pre-index period, or clinical trial participation or end-stage renal disease during the study period were excluded. Patients initiating 1L G-benda were propensity score matched 1:2 with patients initiating 1L R-benda based on age, sex, Charlson Comorbidity Index (CCI), region, and insurance type. All-cause and FL-related (i.e. claim with a FL diagnosis in any position) HRU and costs (2020 USD) per patient per month (PPPM) during the follow-up period were reported. Patients were followed until the earliest of initiation of second-line therapy, end of continuous follow-up, or end of data availability. Results: Overall, 270 patients were included; of these, 90 (33.3%) patients receiving G-benda were matched to 180 (66.7%) patients receiving R-benda for 1L treatment of FL. 45.2% were male, and the mean (standard deviation [SD]) age and CCI at index date were 59.1 (9.9) years and 1.7 (1.1), respectively. Median follow-up was 7.4 months. After matching, baseline characteristics were well-balanced between R-benda and G-benda patients (standardized mean difference [SMD] &lt;0.1). Both all-cause and FL-related HRU were similar between R-benda and G-benda treated patients across all service categories (Figure 1). Total all-cause mean [SD] PPPM costs were also similar in G-benda vs R-benda patients ($21,378 [$15,242] vs $21,352 [$14,145]; p=0.77) (Figure 2). The majority of the total costs were FL-related and comparable across both patient groups: $17,353 ($11,370) for G-benda vs $17,724 ($13,530) for R-benda (p=0.71). Specifically, FL-treatment related costs PPPM were $17,070 ($14,064) for G-benda; this is comparable to $16,138 ($11,828) PPPM for R-benda (p=0.39). Conclusions: Our study found similar total costs of care and HRU among patients receiving 1L G-benda versus those receiving R-benda, providing real-world economic evidence that complements clinical trial data supporting the use of G-chemo for 1L treatment of FL. Figure 1 Figure 1. Disclosures To: Genentech, Inc.: Current Employment; F. Hoffmann-La Roche Ltd: Current equity holder in publicly-traded company, Divested equity in a private or publicly-traded company in the past 24 months. Ta: Genentech, Inc.: Current Employment. Seetasith: Genentech, Inc.: Current Employment; F. Hoffmann-La Roche Ltd: Current equity holder in publicly-traded company. Wang: The SPHERE Institute: Ended employment in the past 24 months; Aurinia Pharmaceuticals Inc.: Current equity holder in publicly-traded company; Novavax, Inc.: Current equity holder in publicly-traded company; Oragenics, Inc.: Current equity holder in publicly-traded company; F. Hoffmann-La Roche Ltd: Current equity holder in publicly-traded company; Genentech, Inc.: Current Employment; TG Therapeutics, Inc.: Current equity holder in publicly-traded company. Lai: Genentech, Inc.: Current Employment, Current equity holder in publicly-traded company; AbbVie: Current equity holder in publicly-traded company, Divested equity in a private or publicly-traded company in the past 24 months, Ended employment in the past 24 months; Bristol-Myers Squibb: Current equity holder in publicly-traded company. Shapouri: Genentech, Inc.: Current Employment; F. Hoffmann-La Roche Ltd: Current equity holder in publicly-traded company.

scholarly journals Healthcare Utilization and Costs of Systemic Lupus Erythematosus in Medicaid

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Hong J. Kan ◽  
Xue Song ◽  
Barbara H. Johnson ◽  
Benno Bechtel ◽  
Donna O'Sullivan ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Healthcare Utilization ◽  
Resource Utilization ◽  
Lupus Erythematosus ◽  
Index Date ◽  
Healthcare Resource ◽  
Healthcare Resource Utilization ◽  
Systemic Lupus ◽  
Medicaid Population ◽  
Annual Total

Objective. Healthcare utilization and costs associated with systemic lupus erythematosus (SLE) in a US Medicaid population were examined.Methods. Patients ≥ 18 years old with SLE diagnosis (ICD-9-CM 710.0x) were extracted from a large Medicaid database 2002–2009. Index date was date of the first SLE diagnosis. Patients with and without SLE were matched. All patients had a variable length of followup with a minimum of 12 months. Annualized healthcare utilization and costs associated with SLE and costs of SLE flares were assessed during the followup period. Multivariate regressions were conducted to estimate incremental healthcare utilization and costs associated with SLE.Results. A total of 14,777 SLE patients met the study criteria, and 14,262 were matched to non-SLE patients. SLE patients had significantly higher healthcare utilization per year than their matched controls. The estimated incremental annual cost associated with SLE was $10,984, with the highest increase in inpatient costs (P<0.001). Cost per flare was $11,716 for severe flares, $562 for moderate flares, and $129 for mild flares. Annual total costs for patients with severe flares were $49,754.Conclusions. SLE patients had significantly higher healthcare resource utilization and costs than non-SLE patients. Patients with severe flares had the highest costs.

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