目的:对于复发/难治性(R/R)弥漫性大B细胞淋巴瘤(DLBCL),有多种最近批准的治疗方法,缺乏明确的标准治疗方法。虽然已通过治疗线(Lot)的数量评估了总护理成本(TCC),需要使用实际数据进行最新的成本估算。该分析使用IQVIAPharMetricsPlus数据库(2015年1月1日至2021年12月31日)评估了LoT对R/RDLBCL疗法的真实TCC,在接受利妥昔单抗联合环磷酰胺治疗的年龄≥18岁的美国患者中,阿霉素,长春新碱,和泼尼松(R-CHOP)或R-CHOP样方案作为一线治疗。方法:通过LoT评估R/R设置中的治疗成本和资源。敏感性分析确定了由COVID-19大流行对医疗保健利用率和成本的影响引起的任何潜在混淆结果。总的来说,包括310名接受二线或后期治疗的患者;整个Lots的基线特征相似。住院费用占总费用的比例最高,其次是门诊和药房费用。结果:每位患者每月的平均TCC通常增加了LoT(第二次为$40,604,$48,630和$59,499,三线和四线治疗,分别)。所有医疗资源利用类别的四线治疗费用最高。敏感性分析结果与总体分析一致,这表明结果没有被COVID-19大流行所混淆。局限性:LoT存在潜在的错误分类;索赔数据是通过算法处理的,可能会引入错误。少数患者符合纳入标准。改变保险计划的病人,保险终止了,或者其注册期满足数据可用性的结束可能已经截断了后续行动,可能导致成本被低估。结论:在R/RDLBCL设置中,随着LoT的增加,总医疗保健成本也会增加。减少对后续Lot的需求的一线治疗的进一步改进将潜在地减轻DLBCL的经济负担。
UNASSIGNED: There are multiple recently approved treatments and a lack of clear standard-of-care therapies for relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL). While total cost of care (TCC) by the number of lines of therapy (LoTs) has been evaluated, more recent cost estimates using real-world data are needed. This analysis assessed real-world TCC of R/R DLBCL therapies by LoT using the IQVIA PharMetrics Plus database (1 January 2015-31 December 2021), in US patients aged ≥18 years treated with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) or an R-CHOP-like regimen as first-line therapy.
UNASSIGNED: Treatment costs and resources in the R/R setting were assessed by LoT. A sensitivity analysis identified any potential confounding of the results caused by the impact of the COVID-19 pandemic on healthcare utilization and costs. Overall, 310 patients receiving a second- or later-line treatment were included; baseline characteristics were similar across LoTs. Inpatient costs represented the highest percentage of total costs, followed by outpatient and pharmacy costs.
UNASSIGNED: Mean TCC per-patient-per-month generally increased by LoT ($40,604, $48,630, and $59,499 for second-, third- and fourth-line treatments, respectively). Costs were highest for fourth-line treatment for all healthcare resource utilization categories. Sensitivity analysis findings were consistent with the overall analysis, indicating results were not confounded by the COVID-19 pandemic.
UNASSIGNED: There was potential misclassification of LoT; claims data were processed through an algorithm, possibly introducing errors. A low number of patients met the inclusion criteria. Patients who switched insurance plans, had insurance terminated, or whose enrollment period met the end of data availability may have had truncated follow-up, potentially resulting in underestimated costs.
UNASSIGNED: Total healthcare costs increased with each additional LoT in the R/R DLBCL setting. Further improvements of first-line treatments that reduce the need for subsequent LoTs would potentially lessen the economic burden of DLBCL.