Health resource utilization and costs of care for adult patients with relapsed or refractory mantle cell lymphoma in the United States: a retrospective claims analysis

Figures & data

Figure 1. Study design schema.

Figure 2. Sample selection flow chart for patients with R/R MCL.

Table 1. Baseline characteristics of patients with R/R MCL.

All Patients	N = 142
Male, n (%)	110 (77.5%)
Age at index, years mean (SD) median	63.9 (10.9) 62.0
Health Plan Type, n (%) Commercial Medicare Supplemental	94 (66.2%) 48 (33.8%)
Charlson Comorbidity Index Score mean (SD) median	3.7 (2.3) 3.0
H-CUP Chronic Conditions Indicator Score mean (SD) median	15.0 (7.5) 14.0
Length of Study Follow-up Period, days mean (SD) median	531.9 (393.2) 178.0

H-CUP = Healthcare Cost and Utilization Project; SD = standard deviation.

Table 2. LoT and time to next treatment for R/R MCL Cohort and among those who received BTKis by LoT.*

	2L (N = 142)	3L (N = 94)	4L+ (N = 33)
R/R MCL Cohort LoT, %	100%	66.2%	23.2%
TTNT, days
mean (SD) median	291.7 (289.7) 178.0	279.2 (299.1) 151.0	188.2 (225.8) 127.0
R/R MCL Cohort who received BTKis	N  = 60	N  = 55	N  = 20
TTNT among R/R MCL Cohort who received BTKis, days
mean (SD) median	132.2 (239.5) 30.0	154.4 (250.1) 55.0	115.2 (117.3) 70.0
BTKi Regimen by LoT, n (%)
Ibrutinib	39 (27.5%)	35 (37.2%)	10 (30.3%)
Acalabrutinib	20 (14.1%)	18 (19.1%)	9 (27.3%)
Zanubrutinib	1 (0.7%)	2 (2.1%)	1 (3.0%)

*It is noted that no patients in this cohort received CAR T, as the study time period was 2016 –2020.

2L = second line; 3L = third line; 4L+ = fourth line and later; BTKi = Bruton tyrosine kinase inhibitor; LoT = line of therapy; SD = standard deviation; TTNT = time to next treatment.

Table 3. All-cause and AE-related HRU and costs (overall and PPPM) for patients with R/R MCL by LoT.*

Healthcare Category	All-Cause HRU and Costs			AE-Related HRU and Costs
	2L	3L	4L+	2L	3L	4L+
N (%) Hospitalized	69/142 (48.6%)	53/94 (56.4%)	21/33 (63.6%)	66/142 (46.5%)	52/94 (55.3%)	21/33 (63.6%)
Length of Stay(days), n mean (SD) median	69 7.6 (10.2) 4.0	53 11.2 (11.2) 8.0	21 11.8 (10.9) 9.0	66 7.6 (10.3) 4.3	52 10.4 (9.1) 7.8	21 12.5 (11.4) 10.0
Total Costs (overall), n mean (SD) median	142 $198,798 ($191,682) $143,695	94 $163,775 ($151,414) $410,425	33 $187,409 ($189,542) $138,731	141 $110,601 ($134,504) $60,666	94 $113,698 ($127,677) $69,890	32 $130,500 ($136,018) $97,119
Total Costs (PPPM), n mean (SD) median	142 $29,999 ($28,423) $21,313	94 $29,352 ($26,958) $20,033	33 $30,633 ($27,954) $23,662	141 $17,756 ($22,244) $13,059	94 $21,072 ($23,321) $15,088	32 $22,267 ($24,431) $16,962
Hospitalizations (PPPM), n mean (SD) median	69 $20,487 ($25,940) $9,642	53 $17,500 ($20,981) $10,272	21 $17,738 ($23,201) $13,560	66 $20,149 ($26,386) $8,093	52 $17,574 ($21,152) $10,392	21 $17,352 ($22,515) $13,560
Office Visits (PPPM), n mean (SD) median	138 $3,923 ($7,495) $391	81 $2,742 ($7,112) $340	23 $2,066 ($2,806) $1,047	106 $1,395 ($3,738) $55	58 $941 ($3,075) $69	16 $357 ($638) $76
Other Outpatient Services (PPPM), n mean (SD) median	137 $12,373 ($15,143) $6,099	90 $9,187 ($13,869) $2,956	31 $10,572 ($2,066) $1,047	120 $3,468 ($6,804) $546	72 $3,190 ($8,410) $362	27 $2,937 ($8,732) $535
ER Visits (PPPM), n mean (SD) median	70 $467 ($807) $184	43 $536 ($722) $227	18 $498 ($866) $131	61 $404 ($723) $117	36 $506 ($745) $186	15 $512 ($933) $130
Prescription Medications (PPPM), n mean (SD) median	140 $4,356 ($5,898) $1,270	93 $8,416 ($14,601) $3,250	32 $8,223 ($8,568) $6,204	140 $4,356 ($5,898) $1,270	93 $8,416 ($14,601) $3,250	32 $8,223 ($8,568) $6,204

*Patients who did not have the encounter (e.g. hospitalization, ICU visit, etc.) and those with zero costs were excluded from that specific outcome result. It is noted that no patients in this cohort received CAR T, as the study time period was 2016 –2020.

2L = second line; 3L = third line; 4L+ = fourth line and later; AEs = adverse events; BTKi = Bruton tyrosine kinase inhibitor; ER = emergency room; HRU = healthcare resource utilization; LoT = line of therapy; PPPM = per patient per month; SD = standard deviation.

Table 4. All-cause and AE-related HRU and costs (overall and PPPM) for patients with R/R MCL who received BTKis within each LoT.*

Healthcare Category	All-Cause HRU and Costs			AE-Related HRU and Costs
	2L	3L	4L+	2L	3L	4L+
N (%) hospitalized	23/60 (38.3%)	26/55 (47.3%)	13/20 (65.0%)	21/60 (35.0%)	26/55 (47.3%)	13/20 (65.0%)
Length of Stay (days), n mean (SD) median	23 8.2 (11.3) 3.0	26 7.7 (5.6) 4.8	13 9.5 (6.8) 8.0	21 8.8 (11.7) 3.8	26 7.7 (5.6) 4.8	13 10.6 (8.4) 9.0
Total Costs (overall), n mean (SD) median	60 $190,550 ($229,129) $121,971	55 $158,181 ($162,026) $120,117	20 $222,265 ($205,094) $165,893	60 $123,377 (166,209) 59806	55 $119,720 ($136,131) $68,059	20 $160,493 ($147,712) $128,973
Total Costs (PPPM), n mean (SD) median	60 $24,702 ($28,839) $17,203	55 $31,801 ($27,131) $20,363	20 $36,710 ($28,994) $25,899	60 $16,261 ($23,408) $14,056	55 $23,889 (23,315) 17,773	20 $30,049 ($27,502) $20,464
Hospitalizations (PPPM), n mean (SD) median	23 $16,234 ($32,855) $5,299	26 $14,712 ($16,450) $8,834	13 $22,151 ($28,117) $13,560	21 $16,615 ($34,433) $4,682	26 $14,712 ($16,450) $8,834	13 $21,527 ($27,279) $13,560
Office Visits (PPPM), n mean (SD) median	58 $2,996 ($7,315) $268	43 $2,328 ($7,712) $318	14 $2,276 ($3,129) $1,256	41 $855 ($2,079) $72	33 $428 ($1,258) $85	10 $533 ($763) $128
Other Outpatient Services (PPPM), n mean (SD) median	56 $9,016 ($13,003) $2,294	52 $10,667 ($16,411) $2,743	19 $8,811 ($13,418) $4,352	47 $3,439 ($7,168) $458	46 $4,467 ($10,275) $595	18 $3,824 ($10,598) $678
ER Visits (PPPM), n mean (SD) median	28 $388 ($794) $156	28 $718 ($827) $296	13 $13,592 ($992) $157	24 $291 ($572) $61	23 $690 ($870) $281	10 $643 ($1,111) $294
Prescription Medications (PPPM), n mean (SD) median	59 $7,290 ($6,601) $5,515	55 $12,941 ($17,374) $9,937	20 $12,349 ($8,262) $11,730	59 $7,290 ($6,601) $5,515	55 $12,941 ($17,374) $9,937	20 $12,349 ($8,262) $11,730

*Patients who did not have the encounter (e.g. hospitalization, ICU visit, etc.) and those with zero costs were excluded from that specific outcome result. It is noted that no patients in this cohort received CAR T, as the study time period was 2016 –2020.

2L = second line; 3L = third line; 4L+ = fourth line and later; AEs = adverse events; BTKi = Bruton tyrosine kinase inhibitor; ER = emergency room; HRU= healthcare resource utilization; LoT = line of therapy; PPPM = per patient per month; SD = standard deviation.

Table 5. All-cause and AE-related HRU and costs (overall and PPPM) for patients with R/R MCL who did not receive BTKis within each LoT.*

Healthcare Category	All-Cause HRU and Costs			AE-related HRU and Costs
	2L	3L	4L+	2L	3L	4L+
N (%) hospitalized	46/82 (56.1%)	27/39 (69.2%)	8/13 (61.5%)	45/82 (54.9%)	26/39 (66.7%)	8/13 (61.5%)
Length of Stay (days), n mean (SD) median	46 7.2 (9.7) 4.4	27 14.5 (14.0) 10.0	8 15.4 (15.2) 11.8	45 7.1 (9.7) 4.4	26 13.2 (12.4) 9.2	8 15.4 (15.2) 11.8
Total Costs (overall), n mean (SD) median	82 $204,833 ($103,848) 88,820	39 $171,664 ($136,725) $144,692	13 $133,785 ($155,120) $45,778	82 $99,904 ($105,171) $60,084	39 $105,205 ($115,907) $98,095	12 $80,511 ($100,450) $48,870
Total Costs (PPPM), n mean (SD) median	82 $33,874 ($27,650) $26,126	39 $25,898 ($26,677) $16,618	13 $21,284 ($24,424) $8,563	82 $18,634 ($21,391) $8,983	39 $17,099 ($23,041) $11,157	12 $9,297 ($9,063) $5,293
Hospitalizations (PPPM), n mean (SD) median	46 $22,613 ($21,799) $26,126	27 20,185 ($24,595) $11,143	8 $10,568 ($9,370) $10,534	45 $21,798 ($21,928) $11,144	26 $20,437 ($25,002) $11,439	8 $10,568 ($9,370) $10,534
Office Visits (PPPM), n mean (SD) median	80 $4,595 ($7,598) $4,375	38 $3,210 ($6,437) $369	9 $1,739 ($2,355) $303	65 $1,736 ($4,462) $48	25 $1,618 ($4,417) $47	6 $63 ($98) $31
Other Outpatient Services (PPPM), n mean (SD) median	81 $14,694 ($16,132) $8,757	38 $7,162 ($9,176) $4,304	12 $13,361 ($22,491) $2,758	73 $3,486 $6,610 $563	$26 $930 ($1,580) $206	9 $1,164 ($1,949) $278
ER Visits (PPPM), n mean (SD) median	42 $520 ($821) $320	15 $197 (231) $147	5 $256 ($367) $75	37 $477 ($806) $230	13 $181 ($230) $142	5 $249 ($372) $75
Prescription Medications (PPPM), n mean (SD) median	81 $2,219 ($4,229) $304	38 $1,866 ($3,880) $169	12 $1,347 ($2,540) $425	81 $2,219 ($4,229) $304	38 $1,866 ($3,880) $169	12 $1,347 ($2,540) $425

*Patients who did not have the encounter (e.g. hospitalization, ICU visit, etc.) and those with zero costs were excluded from that specific outcome result. It is noted that no patients in this cohort received CAR T, as the study time period was 2016–2020. 2L = second line; 3L = third line; 4L+ = fourth line and later; AEs = adverse events; BTKi = Bruton tyrosine kinase inhibitor; ER = emergency room; HRU = healthcare resource utilization; LoT = line of therapy; PPPM = per patient per month; SD = standard deviation.

Table A1. First-line therapies for patients with R/R MCL.

1L Therapies	N = 142
RDHA	2 (1.4%)
RCHOP alone	12 (8.5%)
Nordic regimen	5 (3.5%)
Rituximab alone	7 (4.9%)
Rituximab + bendamustine	43 (30.3%)
Rituximab + lenalidomide	7 (4.9%)
VR+CAP	2 (1.4%)
RBAC500	8 (5.6%)
Other	63 (44.4%)
Autologous stem cell therapy	11 (7.7%)

Table B1. Average (per patient) annualized 2007–2013 cancer-attributable costs in 2020 US dollars for cancer-related medical services by selected cancer site and phase of care.

Cancer Site	Initial Care	Continuing Care	Last Year of Life
Bladder	$26,443	$6,350	$95,984
Breast	$34,980	$3,540	$76,101
Colorectal	$66,524	$6,246	$110,144
Hodgkin lymphoma	$75,373	$9,786	$128,987
Kidney	$41,122	$8,537	$95,985
Leukemia	$47,264	$12,701	$169,588
Acute myeloid leukemia	$190,305	$21,758	$249,125
Liver	$62,776	$18,219	$92,134
Pancreas	$108,166	$18,427	$125,031

Source: [34].

Table C1. Line of therapy definitions.

LoT	Dates	Definition
1L	Treatment Initiation Date	Defined as the date of patients’ 1st claim for the treatment of MCL post Jan 1, 2017, under 1L Induction, 1L Consolidation after aggressive therapy, 1L Maintenance therapy after aggressive therapy, 1L Maintenance after HDT/ASCR, and 1L Maintenance after less aggressive therapy. All treatments administered within the first 45 days of the initiation of the 1st treatment is considered 1L.
1L	Treatment Termination Date	Defined as the earliest date of treatment discontinuation or treatment switch
1L	Treatment Discontinuation Date	Defined as the last date when 1L treatment regimen supply is exhausted. A treatment regimen is considered to be discontinued if there is a gap that exceeds the allowable gap days (90 for oral, 30 for parenteral) + additional treatment-free intervals (defined below for specific treatments) between the last day of the 1L treatment and the 2L treatment. For 1L oral therapy: the prescription days’ supply determines the duration of treatment. The date of the end of days’ supply based on the last observed refill of the oral regimen defines the end of the therapy. If there is a gap of ≥90 days after the end of the therapy, then the end of therapy date is the discontinuation date. For 1L parenteral therapy (i.e. treatments that are administered intravenously): if no other 1L treatments occur within a 30 day interval after the last administration of parenteral therapy, the date of the last administration is considered the 1L treatment discontinuation. For 1L autologous SCT after aggressive therapy: the discontinuation date will be considered the last date of treatment where there exists a gap of 30 days (or more) after the SCT. For combination therapies: If combination therapies occur within the first 45 days of initiation of 1L treatments, the last treatment date that exceeds the specified allowable gap is considered the 1L discontinuation date. Maintenance therapy with rituximab: defined as rituximab monotherapy initiated within an empirically determined time period (i.e. mean duration of rituximab monotherapy treatment cycle) after completion of a rituximab-containing combination therapy (e.g. rituximab/cyclophosphamide/doxorubicin/vincristine [RCHOP], with or without prednisone). If a gap of more than an empirically determined time period (i.e. mean duration of rituximab monotherapy treatment cycle) exists after the last administration of rituximab monotherapy and rituximab monotherapy is the patients’ last 1L treatment, the discontinuation date is considered to be the last date of rituximab monotherapy. For any treatments, if a treatment switch occurs before the discontinuation date, then the switch date will be defined as the discontinuation date.
1	Switch Date	Defined as the start date of treatment not present during the first 45 days of initiation of 1L treatments. This date will also be considered the initiation date of 2L.
2L	Treatment Initiation Date	Defined as the start date of treatment not present during the first 45 days of initiation of 1L treatment.
2L	Treatment Discontinuation Date	Defined as the last date when 2L treatment regimen supply is exhausted. A treatment regimen is considered to be discontinued if there is a gap that exceeds an allowable gap days (90 for oral, 30 for parenteral) + additional treatment-free intervals (defined below for specific treatments) between the last day of the 2L treatment and the initiation of 3L treatment. For 2L oral therapy: the prescription days’ supply will be used to determine the duration of treatment. The date of the end of days’ supply based on the last observed refill of the oral regimen defines the end of the therapy. If there exists a gap of 90 days or more after the end of the therapy, then the end of therapy date is the discontinuation date. For 2L parenteral therapy: if no other 2L treatments occur within a 30 day interval after the last administration, the date of last administration is considered the 2L treatment discontinuation date. If a patient’s 2L treatment is an allogeneic SCT (as consolidation) after the indicated 2L induction therapy, the allogeneic SCT is considered to be within 2L and the discontinuation date will be considered the last date of treatment where there exists a gap of 30 days (or more) after the SCT. For combination therapies: If combination therapies occur within the first 45 days of initiation of 2L treatment, the last treatment date that exceeds the specified allowable gap is considered the 2L discontinuation date. Maintenance therapy with rituximab: is defined as rituximab monotherapy initiated within an empirically determined time period (i.e. mean duration of rituximab monotherapy treatment cycle) after completion of a rituximab-containing combination therapy (e.g. rituximab/cyclophosphamide/doxorubicin/vincristine [RCHOP], with or without prednisone). If a gap of more than an empirically determined time period (i.e. mean duration of rituximab monotherapy treatment cycle) exists after the last administration of rituximab monotherapy and rituximab monotherapy is the patients’ last 2L treatment, the discontinuation date is considered to be the last date of rituximab monotherapy. For any treatments, if a treatment switch occurs before the discontinuation date, then the switch date will be defined as the discontinuation date.
2L	Treatment Switch Date	Defined as the start date of treatment not present during the first 45 days of initiation of 2L. This date is also considered to be the initiation date of 3L.
3L+	Treatment Initiation Date	Defined as the start date of treatment not present during the first 45 days of initiation of 2L OR the date of a new treatment initiating after the 2L treatment discontinuation date as defined above.
3L+	Treatment Termination Date	Defined as the earliest date of the following: end of continuous enrollment, end of data, treatment discontinuation or switch.
3L+	Treatment Discontinuation Date	Defined as the last date when 3L+ treatment regimen supply is exhausted. A treatment regimen is considered to be discontinued if there is a gap that exceeds 30 days + additional treatment-free intervals (defined below for specific treatments) between the last day of the 3L+ treatment and the initiation of next treatment. For 3L+ oral therapy: the prescription days’ supply will be used to determine the duration of treatment. The date of the end of days’ supply based on the last observed refill of the oral regimen, with a subsequent treatment gap ≥90 days, defines the end of the therapy. The end date of the 3L+ therapy for oral regimens will be calculated by adding the total number of days’ supply to the prescription fill date plus the allowed gap of 90 days. treatments) between the last day of the 3L+ treatment and the next treatment. For 3L+ parenteral therapy: if no other 3L+ treatments occur within a 30 day interval after the last administration, the date of the last administration is considered the 3L+ treatment discontinuation date. For 3L+ allogeneic SCT (as consolidation) after the indicated 2L induction therapy: allogeneic SCT is considered to be within 3L+ and the discontinuation date will be considered the last date of the latest 3L+ treatment. For combination therapies: those that are received within the first 30 days of initiation of 3L+ treatments, the last treatment date that exceeds the specified allowable gap is considered the 3L+ discontinuation date. Maintenance therapy with rituximab: will be defined as rituximab monotherapy initiated within an empirically determined time period (i.e. mean duration of rituximab monotherapy treatment cycle) after completion of a rituximab-containing combination therapy (e.g. rituximab/cyclophosphamide/doxorubicin/vincristine [RCHOP], with or without prednisone). If a gap of more than an empirically determined time period (i.e. mean duration of rituximab monotherapy treatment cycle) exists after the last administration of rituximab monotherapy and rituximab monotherapy is the patients’ last 3L+ treatment, the discontinuation date is considered to be the last date of rituximab monotherapy. For any treatments, if a treatment switch occurs before the discontinuation date, then the switch date will be defined as the discontinuation date.
3L+	Treatment Switch Date	Defined as the start date of treatment not present during the first 30 days of initiation of 3L+ . This date will also be considered the initiation date of the next LoT.

Table D1. Table of adverse events for MCL-related treatments.

Adverse Events	MCL-related Treatments
Cardiovascular
Arrhythmia/atrial fibrillation, or ventricular arrhythmia	cytarabine, fludarabine, mitoxantrone, acalabrutinib, ibrutinib
Hypotension	cytarabine
Hypertension	corticosteroids, acalabrutinib, bendamustine/rituximab, rituximab/cyclophosphamide/doxorubicin/vincristine (with or without prednisone)
Gastrointestinal
Nausea/vomiting	cytarabine, mitoxantrone, fludarabine, vincristine sulfate liposomes, acalabrutinib, ibrutinib, bortezomib
Diarrhea	cytarabine, amsacrine, etoposide, mitoxantrone, methotrexate, fludarabine, vincristine sulfate liposomes, nelarabine, ibrutinib (diarrhea), acalabrutinib (diarrhea), bendamustine/rituximab, rituximab/cyclophosphamide/doxorubicin/vincristine (with or without prednisone)
Dehydration	bendamustine/rituximab, rituximab/cyclophosphamide/doxorubicin/vincristine (with or without prednisone)
Hematologic
Cytopenia	cytarabine, fludarabine, mitoxantrone, ibrutinib
Neutropenia	cytarabine, fludarabine, vincristine sulfate liposomes, imatinib, bendamustine/rituximab, rituximab/cyclophosphamide/doxorubicin/vincristine (with or without prednisone), bortezomib
Anemia	vincristine sulfate liposomes, bortezomib
Hypogammaglobulinemia	blinatumomab
Thrombocytopenia	cytarabine, vincristine sulfate liposomes, imatinib, bendamustine/rituximab, rituximab/cyclophosphamide/doxorubicin/vincristine (with or without prednisone), ibrutinib, bortezomib
Leukocytopenia	bortezomib
Hyperglycemia	asparaginase
Bleeding hemorrhage	fludarabine, cytarabine, mitoxantrone, ibrutinib, bendamustine/rituximab, rituximab/cyclophosphamide/doxorubicin/vincristine (with or without prednisone)
Petechiae	acalabrutinib
Hyponatremia	cyclophosphamide
Hypophosphatemia	blinatumomab
Hypokalemia	inotuzumab ozogamicin
Hypocalcemia	inotuzumab ozogamicin
Hypoxia	blinatumomab, tisagenlecleucel
Hypogammaglobulinemia	blinatumomab
Lymphocytopenia	ponatinib, blinatumomab, InO, inotuzumab ozogamicin
Hepatic
Hypertransaminasemia	blinotumomab
Hyperbilirubinemia, elevated liver enzymes	asparaginase
Infections
Infection	cytarabine, mitoxantrone, methotrexate, fludarabine, cytarabine, ibrutinib, bendamustine/rituximab, rituximab/cyclophosphamide/doxorubicin/vincristine (with or without prednisone)
Pyrexia (Fever)	nelarabine, acalabrutinib, ibrutinib, bortezomib
Cytokine release syndrome (CRS)	blinatumomab, tisagenluecleucel
Bacterial infection/sepsis	cytarabine, fludarabine, cytarabine, liposomal daunorubicin, inotuzumab ozogamicin
Fungal infection	cytarabine, fludarabine, cytarabine, liposomal daunorubicin, inotuzumab ozogamicin, imatinib, ibrutinib
Upper respiratory tract infection	acalabrutinib
Pneumonia	cytarabine, inotuzumab ozogamicin
Neurological
Encephalopathy	blinotumomab
Contusion	acalabrutinib
Confusional state	blinotumomab
Headache	inotuzumab ozogamicin, nelarabine, tisagenlecleucel, acalabrutinib
Pulmonary
Respiratory failure	blinatumomab
Renal
Renal toxicity/renal failure	cytarabine, mitoxantrone, methotrexate, fludarabine
Other
Weight gain	nelarabine, acalabrutinib
Fatigue	tisagenlecleucel, nelarabine, acalabrutinib, bortezomib
Rash	Ibrutinib
Arthralgia	acalabrutinib
Myalgia	acalabrutinib

Table E1. Baseline characteristics of patients with R/R MCL^Ŧ.

All Patients	N = 84
Male, n (%)	66 (78.6%)
Age at index, years mean (SD) median	63.8 (10.8) 62.0
Health Plan Type, n (%) Commercial Medicare Supplemental	57 (67.9%) 27 (32.1%)
Charlson Comorbidity Index Score mean (SD) median	3.4 (2.1) 3.0
H-CUP Chronic Conditions Indicator Score mean (SD) median	12.5 (6.3) 11.5
Length of Study Follow-up Period, days mean (SD) median	496.4 (389.1) 413.0

^ŦThese results were previously included in a poster presentation at AMCP Nexus 2022.

Table E2. All-cause HRU and costs (overall and PPPM) for patients with R/R MCL by LoT^Ŧ.

Healthcare Category	All-Cause HRU and Costs*
	n	2L	n	3L	n	4L+
N (%) Hospitalized	84	34 (40.5%)	54	31 (57.4%)	16	10 (62.5%)
Length of Stay, days mean (SD) median	34	7.2 (9.8) 4.3	31	11.4 (11.8) 7.5	10	11.3 (14.9) 5.6
Total Costs, overall mean (SD) median	84	$176,511 ($158,607) $150,078	54	$172,442 ($152,515) $142,880	16	$181,511 ($199,269) $135,562
Total Costs, PPPM mean (SD) median	84	$28,164 ($23,989) $21,182	54	$28,450 ($27,051) $19,754	16	$38,911 ($30,752) $31,869
Hospitalizations, PPPM mean (SD) median	34	$20,450 ($20,001) $11,307	31	$16,501 ($23,660) $8,026	10	$26,558 ($30,839) $16,514
Office Visits, PPPM mean (SD) median	82	$3,800 ($8,324) $276	46	$2,050 ($7,801) $291	10	$1,621 ($2,138) $947
Other Outpatient Services, PPPM mean (SD) median	80	$12,399 ($15,324) $6,238	53	$9,875 ($15,297) $3,124	15	$11,009 ($15,091) $4,426
ER Visits, PPPM mean (SD) median	38	$432 ($701) $236	28	$416 ($674) $156	10	$714 ($1,100) $407
Prescription Medications, PPPM mean (SD) median	82	4,475 ($5,997) $1,321	53	$7,680 ($7,316) $5,541	16	$10,979 ($10,090) $9,251

^ŦThese results were previously included in a poster presentation at AMCP Nexus 2022.

*Patients who did not have the encounter (e.g. hospitalization, ICU visit, etc.) and those with zero costs were excluded from that specific outcome result.

Data availability statement

The data that support the findings of this study are available from Merative. Restrictions apply to the availability of these data, which were used under license for this study. Data are available with permission from Merative.