Real-world healthcare resource utilization and costs in patients with chronic lymphocytic leukemia: differences between patients treated with first-line ibrutinib or bendamustine + rituximab

Abstract

Background

This study evaluated the real-world healthcare resource utilization and costs in chronic lymphocytic lymphoma (CLL) patients treated with first-line ibrutinib monotherapy (IbM) therapy or bendamustine plus rituximab (BR) combination therapy.

Methods

Treatment-naïve CLL patients in the IBM MarketScan Research Databases were identified based on the first prescription of either IbM or BR therapy between 1 February 2014 and 30 August 2017.

Results

A total of 1866 patients with 12 months of continuous enrollment (IbM n = 1157; BR=n = 729) were identified. Thirty-four percent of IbM patients had at least one inpatient admission compared to 24% of BR patients. A total of 31% of IbM patients had at least one CLL-related inpatient admission compared to 20% of BR patients. Among patients with an ER visit, IbM patients visited the emergency room (ER) more frequently than BR patients. There were no differences in total cost, both all-cause and CLL-related, between the IbM and BR cohorts. However, IbM patients had significantly higher all-cause and CLL-related inpatient costs than BR patients as well as all-cause outpatient pharmacy prescriptions costs, while BR patients had significantly higher PPPM outpatient medical costs

Conclusion

The results of this study suggest that further research on the real-world effectiveness of IbM in comparison to BR combination therapy, given the comparatively higher rates of inpatient admissions, longer lengths of stay, and more ER visits observed in IbM patients relative to the BR patients is needed. Given the differences in costs, it is important to further examine the impact these healthcare expenditures have on the cost-effectiveness of IbM first line treatment.

Keywords:

• Healthcare utilization
• healthcare costs
• administrative claims
• real-world data
• cancer

Transparency

Conflict of interest

D. Irwin and K. Wilson are employees of IBM Watson Health who received financial support from Teva for this project. S. Thompson and A. Choudhry are employees of Teva and own stock in Teva.

Acknowledgements

The authors wish to thank Jason Allaire, PhD of Generativity Solutions Group for his assistance with the editing of this paper.

Reviewer statement

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This work was funded by Teva Pharmaceuticals Inc.