Contributions
Abstract: PB1786
Type: Publication Only
Background
Chronic lymphocytic leukemia (CLL) is the most prevalent form of leukemia in adults in western countries, accounting for 20% to 30% of all leukemia cases. CLL affects mainly elderly patients, with a median age at the time of diagnosis reported to be 71 years. Although CLL is not curable, disease symptoms and progression may generally be controlled with adequate pharmacologic treatments. Bendamustine-based regimens have long time been used in the management of CLL patients but few studies have analyzed the comorbidity- and/or adverse event (CAE)-related healthcare costs in elderly patients receiving these regimens in a real-world setting.
Aims
To describe all-cause and CAE-related healthcare costs of elderly patients with CLL treated with a bendamustine-based regimen in second or later lines of therapy in a real-world setting.
Methods
A retrospective cross-sectional cohort study design was used. Adult patients who received a bendamustine-based regimen in second or later lines of therapy on or after January 2010 were identified from the Medicare Limited Data Set (LDS) 5% Standard Analytic Files (data availability: 1999–2014). The index date was defined as the initiation date for the first of the studied bendamustine-based regimens. Selected patients were required to be continuously enrolled in their Medicare plan for ≥6 months before and ≥3 months after the index date – unless the patient died during the first 3 months after the index date. Patient cohorts were determined based on the treatment initiated on the index date (index treatment); the two most prevalent bendamustine-based regimens were analyzed, i.e., (1) bendamustine and rituximab in combination (BR cohort) and (2) bendamustine monotherapy (bendamustine cohort). Healthcare costs, including inpatient, emergency room, outpatients and CLL-drug costs, incurred while treated with the index treatment were described for each cohort. For each medical cost component, all-cause and CAE-related costs were summarized. Healthcare costs were adjusted for inflation (2016 USD) and reported per-patient-per-month (PPPM).
Results
A total of 275 patients were included in the BR cohort and a total of 100 patients in the bendamustine cohort. Most patients (61,8% in the BR cohort and 65,0% in the bendamustine cohort) were male and the mean age was approximately 75 years old. During the 6 months prior to the index date, patients in the BR and bendamustine cohorts were similar in terms of commorbidity profile; mean Charlson comorbidity index was 3.53 in the BR cohort versus 3.66 in the bendamustine cohort (p=0.580). During treatment, total all-cause healthcare costs were $14,520 PPPM for the BR cohort and $13,125 PPPM for the bendamustine cohort – outpatient costs (mainly driven by CLL-drug costs) represented the largest cost component. CAE costs accounted for a relatively large portion of the total all-cause healthcare costs; 58.3% for the BR cohort and 66.9% for the bendamustine cohort.
Conclusion
In this population of elderly patients previously treated for CLL, healthcare costs incurred during relapsed treatment with bendamustine-based regimens were high and a large portion of the costs were driven by comorbidity and/or adverse event-related costs. Results also suggest that the addition of rituximab to bendamustine does not appear to be a major cost factor.
Session topic: 6. Chronic lymphocytic leukemia and related disorders - Clinical
Keyword(s): Health care, Cost analysis, Chronic Lymphocytic Leukemia
Abstract: PB1786
Type: Publication Only
Background
Chronic lymphocytic leukemia (CLL) is the most prevalent form of leukemia in adults in western countries, accounting for 20% to 30% of all leukemia cases. CLL affects mainly elderly patients, with a median age at the time of diagnosis reported to be 71 years. Although CLL is not curable, disease symptoms and progression may generally be controlled with adequate pharmacologic treatments. Bendamustine-based regimens have long time been used in the management of CLL patients but few studies have analyzed the comorbidity- and/or adverse event (CAE)-related healthcare costs in elderly patients receiving these regimens in a real-world setting.
Aims
To describe all-cause and CAE-related healthcare costs of elderly patients with CLL treated with a bendamustine-based regimen in second or later lines of therapy in a real-world setting.
Methods
A retrospective cross-sectional cohort study design was used. Adult patients who received a bendamustine-based regimen in second or later lines of therapy on or after January 2010 were identified from the Medicare Limited Data Set (LDS) 5% Standard Analytic Files (data availability: 1999–2014). The index date was defined as the initiation date for the first of the studied bendamustine-based regimens. Selected patients were required to be continuously enrolled in their Medicare plan for ≥6 months before and ≥3 months after the index date – unless the patient died during the first 3 months after the index date. Patient cohorts were determined based on the treatment initiated on the index date (index treatment); the two most prevalent bendamustine-based regimens were analyzed, i.e., (1) bendamustine and rituximab in combination (BR cohort) and (2) bendamustine monotherapy (bendamustine cohort). Healthcare costs, including inpatient, emergency room, outpatients and CLL-drug costs, incurred while treated with the index treatment were described for each cohort. For each medical cost component, all-cause and CAE-related costs were summarized. Healthcare costs were adjusted for inflation (2016 USD) and reported per-patient-per-month (PPPM).
Results
A total of 275 patients were included in the BR cohort and a total of 100 patients in the bendamustine cohort. Most patients (61,8% in the BR cohort and 65,0% in the bendamustine cohort) were male and the mean age was approximately 75 years old. During the 6 months prior to the index date, patients in the BR and bendamustine cohorts were similar in terms of commorbidity profile; mean Charlson comorbidity index was 3.53 in the BR cohort versus 3.66 in the bendamustine cohort (p=0.580). During treatment, total all-cause healthcare costs were $14,520 PPPM for the BR cohort and $13,125 PPPM for the bendamustine cohort – outpatient costs (mainly driven by CLL-drug costs) represented the largest cost component. CAE costs accounted for a relatively large portion of the total all-cause healthcare costs; 58.3% for the BR cohort and 66.9% for the bendamustine cohort.
Conclusion
In this population of elderly patients previously treated for CLL, healthcare costs incurred during relapsed treatment with bendamustine-based regimens were high and a large portion of the costs were driven by comorbidity and/or adverse event-related costs. Results also suggest that the addition of rituximab to bendamustine does not appear to be a major cost factor.
Session topic: 6. Chronic lymphocytic leukemia and related disorders - Clinical
Keyword(s): Health care, Cost analysis, Chronic Lymphocytic Leukemia