Real-World Treatment Patterns, Survival, Health Resource use and Costs Among Medicare Beneficiaries with Diffuse Large B-Cell Lymphoma

Abstract

Aim:

To examine real-world treatment patterns, survival, healthcare resource use and costs in elderly Medicare beneficiaries with diffuse large B-cell lymphoma (DLBCL).

Methods:

11,880 Medicare patients aged ≥66 years with DLBCL between 1 October 2015 and 31 December 2018 were followed for ≥12 months after initiating front-line treatment.

Results:

Two-thirds (61.2%) of the patients received standard-of-care R-CHOP as first-line treatment. Hospitalization was common (57%) in the 12-months after initiation of 1L treatment; the mean DLCBL-related total costs were US$84,416 during the same period. Over a median follow-up of 2.1 years, 17.8% received at least 2L treatment. Overall survival was lower among later lines of treatment (median overall survival from initiation of 1L: not reached; 2L: 19.9 months; 3L: 9.8 months; 4L: 5.5 months).

Conclusion:

A large unmet need exists for more efficacious and well-tolerated therapies for older adults with DLBCL.

Plain Language Summary

Plain language summary – Older patients with DLBCL need more effective treatments

Diffuse large B-cell lymphoma (DLBCL) is the most common form of Non-Hodgkin lymphoma, and it becomes more common with age. While researchers continue to develop newer, more effective treatments for DLBCL, it is important to understand how patients use existing treatments and the associated costs, particularly among the elderly. In our real-world analysis of nearly 12,000 older patients with DLBCL, we found high rates of hospitalization and hospice use, short length of life in later lines of therapy and substantial healthcare costs. Our findings suggest a large current unmet need for more effective and well-tolerated therapies for older adults with DLBCL in both the front-line and relapse/refractory settings.

Tweetable abstract

A real-world analysis of nearly 12,000 elderly patients with DLBCL observed high rates of hospitalization and hospice use, poor overall survival in later lines of therapy and substantial healthcare costs, suggesting a large unmet need.

Keywords::

• costs
• diffuse large B-cell lymphoma
• elderly
• Medicare
• survival
• treatment patterns

Supplementary data

To view the supplementary data that accompany this paper please visit the journal website at: www.tandfonline.com/doi/suppl/10.2217/fon-2023-0191

Financial disclosure

This study was funded by Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA. The sponsor was involved in the interpretation of results and drafting of the manuscript. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Competing interests disclosure

M Garg, M Raut and KE Ryland are employees of Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA. J Puckett and S Kamal-Bahl are employees of COVIA Health Solutions, a consulting form with clients in the biotech/pharmaceutical industry. SF Huntington: consultancy for Janssen, Pharmacyclics, AbbVie, AstraZeneca, Flatiron Health Inc., Novartis, SeaGen, Genetech, Merck, TG Therapeutics, ADC Therapeutics, Epizyme, Servier, Arvinas, and Thyme Inc.; research funding from Celgene, DTRM Biopharm, and TG Therapeutics; honoraria form Pharmacyclics and AstraZeneca, Bayer; JA Doshi: consultancy for AbbVie, Acadia, Janssen, Merck, Otsuka, and Takeda; research funding from Merck and Spark Therapeutics. The authors have no other competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript apart from those disclosed.

Writing disclosure

No writing assistance was utilized in the production of this manuscript.