Real-world treatment patterns and health care resource utilization (HRU) among patients with chronic lymphocytic leukemia (CLL) by regimen.

Authors

null

Brad Schenkel

Janssen Scientific Affairs, LLC, Horsham, PA

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

Organizations

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

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 U.S. claims database from 1/2007-10/2013 was conducted. Adult CLL pts (≥2 claims for CLL) with ≥1 claim for systemic anticancer therapy (SACT) were identified; first SACT claim date was the index date. Pts had to have a CLL diagnosis ≤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 first 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 years, 63% were male, and by insurance type, 41% were Medicare Advantage vs. 59% commercially insured. During the first 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 first 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 second LOT. 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 first LOTFCR (183 patients)R (180 patients)BR (169 patients)
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

2016 ASCO Quality Care Symposium

Session Type

Poster Session

Session Title

Poster Session A: Practice of Quality and Cost, Value, and Policy in Quality

Track

Cost, Value, and Policy in Quality,Practice of Quality,Science of Quality

Sub Track

Measuring Value and Costs

Citation

J Clin Oncol 34, 2016 (suppl 7S; abstr 15)

DOI

10.1200/jco.2016.34.7_suppl.15

Abstract #

15

Poster Bd #

B12

Abstract Disclosures

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