Real-world healthcare resource utilization and costs associated with tisagenlecleucel and axicabtagene ciloleucel among patients with diffuse large B-cell lymphoma: an analysis of hospital data in the United States

Abstract

This study compared the real-world healthcare resource utilization (HRU), costs, adverse events (AEs), and AE treatments associated with the chimeric antigen receptor T-cell (CAR-T) therapies, tisagenlecleucel (tisa-cel) and axicabtagene ciloleucel (axi-cel), for relapsed/refractory diffuse large B-cell lymphoma (r/r DLBCL). Adults with DLBCL who received tisa-cel or axi-cel were identified in the Premier Healthcare Database (2017–2020). Non-CAR-T costs, HRU, and AE rates during the infusion and follow-up periods were compared between the tisa-cel and axi-cel cohorts. Of 119 patients, 33 received tisa-cel (86% as inpatient infusion) and 86 received axi-cel (100% inpatient). Tisa-cel was associated with significantly shorter mean inpatient length of stay than axi-cel during infusion (11.3 vs. 18.3 days) and follow-up ([monthly] 3.9 vs. 6.9 days). Non-CAR-T costs were significantly lower for tisa-cel compared with axi-cel during infusion ($27594.8 vs. $51378.3) and follow-up ([monthly] $28777.3 vs. $46575.7; both p< .05). Rates of AEs and AE treatments were similar.

Keywords:

• Adverse events
• axicabtagene ciloleucel
• diffuse large B-cell lymphoma
• healthcare costs
• healthcare resource utilization
• tisagenlecleucel

Acknowledgements

Medical writing was provided by Shelley Batts, PhD, an employee of Analysis Group, Inc. Support for this assistance was provided by Novartis Pharmaceuticals Corporation.

Ethics approval and consent to participate: As the claims data used in this study were deidentified, no Institutional Review Board oversight was required.

Author contributions

All authors contributed to the study concept, design, and data interpretation. Qing Liu, Travis Wang, Jing Zhao, and Hongbo Yang conducted data analyses. Hongbo Yang, Qing Liu, and Shelley Batts (the medical writer) wrote the manuscript. All authors critically revised the manuscript along with the medical writer and approved the current version for submission. Richard T. Maziarz is the guarantor of this manuscript.

Disclosure statement

Hongbo Yang, Qing Liu, Travis Wang, and Jing Zhao are employees of Analysis Group, Inc., which has received consulting fees from Novartis Pharmaceuticals Corporation. Soyon Lee, Stephen Lim, Anand Dalal, and Vamsi Bollu are employees of Novartis Pharmaceuticals Corporation and hold stock/options. Richard T. Maziarz is an advisor or consultant for AlloVir, Artiva, CRISPR Therapeutics, Incyte, and Novartis; reports honoraria from Incyte, and Intellia; research support from BMS, AlloVir, and Novartis; participation in a data and safety monitoring board for Athersys, Vor Pharma, and Novartis; and a patent with Athersys.

Data availability statement

The data were provided to the authors under an agreement with Premier Healthcare Solution, Inc. Researchers can request access from Premier directly and pay the applicable fee (https://products.premierinc.com/applied-sciences/solutions).

Additional information

Funding

This work was supported by Novartis Pharmaceuticals Corporation.