https://orcid.org/0000-0003-2800-1470
Abstract
Aim: To describe treatment patterns and economic burden in patients with mantle cell lymphoma (MCL). Patients & methods: A retrospective cohort study of adults with MCL utilizing commercial claims (2015–2021) was conducted. Results: The most common regimens were bendamustine plus rituximab-based (28.5%) and rituximab-cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP)/CHOP-based (17.6%) in first-line (1L), hematopoietic stem cell transplantation (HSCT) in second-line (2L; 23.9%) and rituximab in third-line (3L; 43.7%) treatment. Respective to 1L, 2L and 3L, approximately 9.6%, 14.0% and 19.8% of patients received Bruton tyrosine kinase inhibitors, and mean total healthcare costs were $262,529, $365,892 and $260,744 per patient per year. Conclusion: Patients with MCL received guideline-concordant therapies and incurred substantial healthcare resource utilization and costs.
TWEETABLE ABSTRACT
In this real-world analysis, patients with MCL received guideline-concordant therapies and incurred substantial healthcare resource utilization and cost, highlighting a need for novel agents.
Previous studies on treatment patterns and economic burden of patients with mantle cell lymphoma (MCL) have not focused on the changing treatment landscape. Few studies assessed healthcare resource utilization and costs by treatment lines.
In the USA, commercial claims data offers an opportunity to examine nationally-representative, new MCL treatment patterns and resource use.
In this study, the predominant treatment regimens, bendamustine plus rituximab (28.5%) and rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone (17.6%) in first line (1L) and rituximab (16.9% and 43.7%, respectively) in second line (2L) and third line (3L), were consistent with the current guidelines and other studies.
There was an increasing trend of hematopoietic stem cell transplantation therapy in later lines of treatments (23.9% in 2L and 16.7% in 3L) and Bruton tyrosine kinase inhibitors-based regimens (9.6, 14.0 and 19.8% for 1L, 2L and 3L, respectively).
Our study reported higher mean all-cause medical costs ($19,759 per patient per month or $237,113 per patient per year in 1L) as compared with the total medical costs from previous reports. It could be attributed to new treatment choices or different follow-up periods.
Overall, inpatient costs were the largest driver of total all-cause medical costs, followed by outpatient and office-based costs.
The study provides novel information for the most recent changes in MCL treatment patterns and associated economic burden for payers and patients.
Author contributions
SJ Keating made substantial contributions to conception or design of the study and data interpretation; J Qian, S Inguva and R Shah made substantial contributions to conception or design of the study, data acquisition, data analysis and data interpretation. V Chirikov made substantial contributions to data interpretation. All authors contributed to and approved the manuscript.
Financial disclosure
SJ Keating was an employee of Bristol Myers Squibb at the time the research was conducted and is a current shareholder of Bristol Myers Squibb. S Inguva, J Qian and R Shah were employees of OPEN Health at the time of the study, which received consulting fees from Bristol Myers Squibb for conducting this analysis. V Chirikov is an employee of OPEN Health, which received consulting fees from Bristol Myers Squibb for conducting this analysis. This study was funded by Bristol Myers Squibb. 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
The authors have no competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
Writing disclosure
Writing and editorial assistance were provided by B Reinen and J Henriques of The Lockwood Group (Stamford, CT, USA), and were funded by Bristol Myers Squibb.
Ethical conduct of research
This study followed the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) reporting guideline for observational cohort studies. The study included data from commercial claims databases; therefore, institutional review board approval and informed consent were not required per 45 CFR 46.101(b)(4).
Data sharing statement
Bristol Myers Squibb policy on data sharing may be found at https://www.bms.com/researchers-and-partners/independent-research/data-sharing-request-process.html.