TITLE:
Overall Survival and Health Care Costs of Medicare Patients with Previously Treated Chronic Lymphocytic Leukemia
AUTHORS:
Carolina Reyes, Genevieve Gauthier, Sherry Shi, Annie Guerin
KEYWORDS:
Chronic Lymphocytic Leukemia, Relapse/Refractory, Bendamustine, Economic Burden, Overall Survival, Adverse Events
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.9 No.7,
July
23,
2018
ABSTRACT: Background: Bendamustine-based regimens are often used in the management of patients
with chronic lymphocytic leukemia (CLL) but few studies have analyzed the
comorbidity- and/or adverse event (CAE)-related healthcare costs in patients receiving
these regimens in a real-world setting. Aims: To describe all-cause and
CAE-related healthcare costs in relapse/refractory (R/R) elderly patients with
CLL treated with bendamustine-based regimens in a real-world setting. Methods: Adult patients with R/R CLL who received bendamustine-based regimens on/after
January 2010 were selected from the Medicare Limited Data Set (LDS) 5% Standard
Analytic Files. Selected patients were classified into cohorts based on the two
most prevalent bendamustine-based regimens observed (index treatment): 1) bendamustine
+ rituximab (BR cohort) and 2) bendamustine monotherapy (B-mono cohort). For
each cohort, all-cause and CAE-related healthcare costs, while on treatment,
were reported per-patient-per-month (PPPM). Overall survival (OS) rates
following initiation of the index treatment were described using age- and
gender-adjusted Kaplan-Meier curves. Results: A total of 275 patients were
included in the BR cohort and 100 patients in the B-mono cohort. Most patients
were male and the mean age was approximately 75 years old. During treatment, total
all-cause healthcare costs were $14,520 PPPM for the BR cohort and $13,125 PPPM
for the B-mono cohort—outpatient costs (mainly driven by CLL-drug costs)
represented 86.1% of the total all-cause healthcare costs for the BR cohort and
69.8% for the B-mono cohort. CAE costs accounted for 58.3% of the total
all-cause healthcare costs for the BR cohort and 66.9% for the B-mono cohort. Median
OS was 35 months in the BR cohort and 21 months in the B-mono cohort. Conclusion: In this population of elderly patients with R/R CLL treated with
bendamustine-based regimens, CAEs were common and translated into important
medical costs. Median OS was also relatively short suggesting an unmet medical
need.