Treatment Patterns and Health Care Costs in Commercially Insured Patients with Follicular Lymphoma

**Background:** Few studies have estimated the real-world economic burden such as all-cause and follicular lymphoma-related costs and health care resource utilization (HCRU) in patients with follicular lymphoma (FL). **Objectives:** This study evaluated outcomes in patients who were newly initiate...

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Main Authors: Nathan H. Fowler, Guifang Chen, Stephen Lim, Stephanie Manson, Qiufei Ma, Frank Li
Format: Article
Language:English
Published: Columbia Data Analytics, LLC 2020-09-01
Series:Journal of Health Economics and Outcomes Research
Online Access:https://doi.org/10.36469/jheor.2020.16784
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author Nathan H. Fowler
Guifang Chen
Stephen Lim
Stephanie Manson
Qiufei Ma
Frank Li
author_facet Nathan H. Fowler
Guifang Chen
Stephen Lim
Stephanie Manson
Qiufei Ma
Frank Li
author_sort Nathan H. Fowler
collection DOAJ
description **Background:** Few studies have estimated the real-world economic burden such as all-cause and follicular lymphoma-related costs and health care resource utilization (HCRU) in patients with follicular lymphoma (FL). **Objectives:** This study evaluated outcomes in patients who were newly initiated with FL indicated regimens by line of therapy with real-world data. **Methods:** A retrospective study was conducted among patients with FL from MarketScan® databases between January 1, 2010 and December 31, 2013. Patients were selected if they were ≥18 years old when initiated on a FL indicated therapy, had at least 1 FL-related diagnosis, ≥1 FL commonly prescribed systemic anti-cancer therapy after diagnosis, and did not use any FL indicated regimen in the 24 months prior to the first agent. These patients were followed up at least 48 months and the outcomes, including the distribution of regimens by line of therapy, the treatment duration by line of therapy, all-cause and FL-related costs, and HCRU by line of therapy were evaluated. **Results:** This study identified 598 patients who initiated FL indicated treatment. The average follow-up time was approximately 5.7 years. Of these patients, 50.2% (n=300) were female, with a mean age of 60.7 years (SD=13.1 years) when initiating their treatment with FL indicated regimens. Overall, 598 (100%) patients received first-line therapy, 180 (43.6%) received second-line therapy, 51 received third-line therapy, 21 received fourth-line therapy, and 10 received fifth-line therapy. Duration of treatment by each line of therapy was 370 days, 392 days, 162 days, 148 days, and 88 days, respectively. The most common first-line regimens received by patients were rituximab (n=201, 33.6%), R-CHOP (combination of rituximab, cyclophosphamide, doxorubicin hydrochloride [hydroxydaunomycin]; n=143, 24.0%), BR (combination of bendamustine and rituximab; n=143, 24.0%), and R-CVP (combination of rituximab, cyclophosphamide, vincristine, and prednisone; n=71, 11.9%). The most common second-line treatment regimens were (N=180): rituximab (n=78, 43.3%) and BR (n=41, 22.8%). Annualized all-cause health care costs per patient ranged from US$97 141 (SD: US$144 730) for first-line to US$424 758 (SD: US$715 028) for fifth-line therapy. **Conclusions:** The primary regimens used across treatment lines conform to those recommended by the National Comprehensive Cancer Network clinical practice guidelines. The economic burden for patients with FL is high and grows with subsequent lines of therapy.
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spelling doaj-art-896612dd96444804ba2151b2eec04e3d2025-02-10T16:13:17ZengColumbia Data Analytics, LLCJournal of Health Economics and Outcomes Research2327-22362020-09-0172Treatment Patterns and Health Care Costs in Commercially Insured Patients with Follicular LymphomaNathan H. FowlerGuifang ChenStephen LimStephanie MansonQiufei MaFrank Li**Background:** Few studies have estimated the real-world economic burden such as all-cause and follicular lymphoma-related costs and health care resource utilization (HCRU) in patients with follicular lymphoma (FL). **Objectives:** This study evaluated outcomes in patients who were newly initiated with FL indicated regimens by line of therapy with real-world data. **Methods:** A retrospective study was conducted among patients with FL from MarketScan® databases between January 1, 2010 and December 31, 2013. Patients were selected if they were ≥18 years old when initiated on a FL indicated therapy, had at least 1 FL-related diagnosis, ≥1 FL commonly prescribed systemic anti-cancer therapy after diagnosis, and did not use any FL indicated regimen in the 24 months prior to the first agent. These patients were followed up at least 48 months and the outcomes, including the distribution of regimens by line of therapy, the treatment duration by line of therapy, all-cause and FL-related costs, and HCRU by line of therapy were evaluated. **Results:** This study identified 598 patients who initiated FL indicated treatment. The average follow-up time was approximately 5.7 years. Of these patients, 50.2% (n=300) were female, with a mean age of 60.7 years (SD=13.1 years) when initiating their treatment with FL indicated regimens. Overall, 598 (100%) patients received first-line therapy, 180 (43.6%) received second-line therapy, 51 received third-line therapy, 21 received fourth-line therapy, and 10 received fifth-line therapy. Duration of treatment by each line of therapy was 370 days, 392 days, 162 days, 148 days, and 88 days, respectively. The most common first-line regimens received by patients were rituximab (n=201, 33.6%), R-CHOP (combination of rituximab, cyclophosphamide, doxorubicin hydrochloride [hydroxydaunomycin]; n=143, 24.0%), BR (combination of bendamustine and rituximab; n=143, 24.0%), and R-CVP (combination of rituximab, cyclophosphamide, vincristine, and prednisone; n=71, 11.9%). The most common second-line treatment regimens were (N=180): rituximab (n=78, 43.3%) and BR (n=41, 22.8%). Annualized all-cause health care costs per patient ranged from US$97 141 (SD: US$144 730) for first-line to US$424 758 (SD: US$715 028) for fifth-line therapy. **Conclusions:** The primary regimens used across treatment lines conform to those recommended by the National Comprehensive Cancer Network clinical practice guidelines. The economic burden for patients with FL is high and grows with subsequent lines of therapy.https://doi.org/10.36469/jheor.2020.16784
spellingShingle Nathan H. Fowler
Guifang Chen
Stephen Lim
Stephanie Manson
Qiufei Ma
Frank Li
Treatment Patterns and Health Care Costs in Commercially Insured Patients with Follicular Lymphoma
Journal of Health Economics and Outcomes Research
title Treatment Patterns and Health Care Costs in Commercially Insured Patients with Follicular Lymphoma
title_full Treatment Patterns and Health Care Costs in Commercially Insured Patients with Follicular Lymphoma
title_fullStr Treatment Patterns and Health Care Costs in Commercially Insured Patients with Follicular Lymphoma
title_full_unstemmed Treatment Patterns and Health Care Costs in Commercially Insured Patients with Follicular Lymphoma
title_short Treatment Patterns and Health Care Costs in Commercially Insured Patients with Follicular Lymphoma
title_sort treatment patterns and health care costs in commercially insured patients with follicular lymphoma
url https://doi.org/10.36469/jheor.2020.16784
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