Real world treatment patterns and healthcare resource utilization (HRU) among chronic lymphocytic leukemia (CLL) patients by regimen.

Authors

null

Stacey DaCosta Byfield

OptumInsight, Eden Prairie, MN

Stacey DaCosta Byfield , Stephanie Korrer , Lorie Ellis , Brad Schenkel

Organizations

OptumInsight, Eden Prairie, MN, Optum, Eden Prairie, MN, Janssen Scientific Affairs, LLC, Horsham, PA

Research Funding

No funding sources reported

Background: Few studies examine HRU of CLL, the most common hematologic malignancy in adults. This study describes HRU by the most common regimens among CLL patients (pts). Methods: A retrospective study using a large, national US claims database from 1/2007-10/2013 was conducted. Adult CLL pts (≥2 claims for CLL) with ≥1 claim for systemic anti-cancer therapy (SACT) were identified; first SACT claim date was the index date. Pts had to have a CLL diagnosis within 3 months (m) prior to the index date and be continuously enrolled (CE) in the health plan for 24m pre- and ≥6m post-index date. Pregnant pts and those with SACT in the pre-index period were excluded. A line of therapy (LOT) started with the first SACT; regimens included all agents received in the 1st 60 days. LOTs ended at the earliest of, start of a new drug, ≥60-day gap in receipt of initial regimen drugs, death or CE end. All-cause HRU was examined by regimen. Results: There were 946 CLL pts identified. Mean age was 68 yrs, 63% were male and by insurance type, 41% were Medicare Advantage vs. 59% commercially insured. During the 1st LOT, 96% and 78% of pts had ≥1 office or hospital outpatient visit with mean per patient per month (PPPM) visits of 4.3 (standard deviation, SD=2.8) and 2.2 (SD=2.8), respectively. 31% and 25% had ≥1 ER visit or inpatient stay with mean PPPM visits of 0.2 (SD=0.4) and 0.1 (SD=0.3), respectively. Mean PPPM count of inpatient stay days was 1.4 (SD=8.0). In 1st LOT, the top 3 regimens accounted for 56% of pts: FCR: fludarabine, cyclophosphamide, rituximab (19%); R: rituximab (19%); BR: bendamustine, rituximab (18%). During the study period, 318 pts (34%) started a 2ndLOT. The top 3 LOT2 regimens accounted for 52% of pts: R (30%); BR (14%); chlorambucil (8%). Conclusions: HRU of CLL pts varied by initial regimen received. Future studies should examine influences of regimen choice and whether regimen choice is associated with differences in outcomes.

HRU in 1st LOTFCR
N=183
R
N=180
BR
N=169
Office visit
%989698
PPPM^5.1 (2.8)3.9 (2.3)4.2(2.6)
Hospital outpatient visits
%836783
PPPM^2.3 (2.6)1.9 (2.9)2.4 (3.0)
ER visits
%322137
PPPM^0.1 (0.3)0.2 (0.5)0.2 (0.3)
Inpatient stays
%251533
PPPM^0.1 (0.2)0.1 (0.2)0.1 (0.3)
^mean (SD)

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Abstract Details

Meeting

2015 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Publication Only: Leukemia, Myelodysplasia, and Transplantation

Track

Hematologic Malignancies—Leukemia, Myelodysplastic Syndromes, and Allotransplant

Sub Track

Leukemia

Citation

J Clin Oncol 33, 2015 (suppl; abstr e18043)

DOI

10.1200/jco.2015.33.15_suppl.e18043

Abstract #

e18043

Abstract Disclosures

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