Costs associated with follicular lymphoma among individuals diagnosed with non-Hodgkin lymphoma: a longitudinal analysis using SEER-Medicare data

Abstract

There is limited information on the cost burden associated with follicular lymphoma (FL) and how it compares to other non-Hodgkin lymphoma (NHL) subtypes. We examined the direct medical costs associated with FL and estimated the incremental 3-year cost of FL compared to other NHL subtypes. Using the linked Surveillance, Epidemiology and End Results-Medicare dataset, we identified 16,691 NHL patients aged 66 years or older who were diagnosed with NHL between 2007 and 2013. The mean 3-year cost among the full NHL sample was $120,120 (standard error (SE) 839). The mean 3-year cost per patient was $114,443 (SE 1738) for FL and $121,402 (SE 950) for non-FL subtypes. The incremental 3-year cost of FL compared to non-FL was US$-5458 (95% confidence interval: US$-9325 to US$-1590). Longitudinally, FL was less costly than other NHL subtypes in the first year only, and became more expensive in the second and third years.

Keywords:

• Non-Hodgkin lymphoma
• follicular lymphoma
• cost burden
• economic burden
• comparative cost of illness

Acknowledgements

The study team thanks Dr. Adriana Valderrama for her insights and valuable feedback which greatly assisted the conceptualization of this study. We also thank the Pharmaceutical Research Computing at the University of Maryland School of Pharmacy for staff assistance and primary data management.

This study used the linked SEER-Medicare database. The interpretation and reporting of these data are the sole responsibility of the authors. The authors acknowledge the efforts of the National Cancer Institute; the Office of Research, Development and Information, CMS; Information Management Services (IMS), Inc.; and the SEER Program tumor registries in the creation of the SEER-Medicare database. The ideas and opinions expressed herein are those of the author(s) and endorsement by the State of California Department of Public Health, the National Cancer Institute, and the Centers for Disease Control and Prevention or their Contractors and Subcontractors is not intended nor should be inferred.

Disclosure statement

Mr. Albarmawi, Dr. Nagarajan, Mr. Sun, Mr. Gandhi, and Dr. Yared declare that they have no conflict of interest; Dr. Keating, Dr. Appukkuttan, and Dr. Yaldo are employees of Bayer US LLC; Dr. Gharibo was an employee of Bayer U.S. LLC; Dr. Onukwugha reports grant funding from Bayer Healthcare Pharmaceuticals and Pfizer, Inc. as well as consulting fees from Novo Nordisk.

Author contributions

Husam Albarmawi: Conception/Design, Data analysis and interpretation, Manuscript writing, Final approval of manuscript. Madhuram Nagarajan: Conception/Design, Manuscript writing, Final approval of manuscript. Kai Sun: Conception/Design, Assembly of data, Data analysis, Manuscript writing, Final approval of manuscript. Aakash Gandhi: Conception/Design, Manuscript writing, Final approval of manuscript. Jean Yared: Conception/Design, Data analysis and interpretation, Manuscript writing, Final approval of manuscript. Karen N. Keating: Conception, Manuscript writing, Final approval of manuscript. Sreevalsa Appukkuttan: Conception, Manuscript writing, Final approval of manuscript. Avin Yaldo: Conception, Manuscript writing, Final approval of manuscript. Mecide Gharibo: Conception, Manuscript writing, Final approval of manuscript. Eberechukwu Onukwugha: Conception/Design, Provision of study material, Data analysis and interpretation, Manuscript writing, Final approval of manuscript.

Additional information

Funding

The collection of cancer incidence data used in this study was supported by the California Department of Public Health as part of the statewide cancer reporting program mandated by California Health and Safety Code Section 103885; the National Cancer Institute's Surveillance, Epidemiology and End Results Program under contract HHSN261201000140C awarded to the Cancer Prevention Institute of California, contract HHSN261201000035C awarded to the University of Southern California, and contract HHSN261201000034C awarded to the Public Health Institute; and the Centers for Disease Control and Prevention's National Program of Cancer Registries, under agreement # U58DP003862-01 awarded to the California Department of Public Health. Financial support for this study was provided by Bayer HealthCare Pharmaceuticals under Grant [201603311353].