Health care resource utilization (HCRU) and total costs of care (TCOC) among patients (pts) with diffuse large B-cell lymphoma (DLBCL) treated with chimeric antigen receptor (CAR) T-cell therapies in the United States: An analysis of four claims databases.

Authors

null

Scott J. Keating

Bristol-Myers Squibb Company, Summit, NJ

Scott J. Keating, Tao Gu, Monika Parisi Jun, Corey Pelletier, Ali McBride

Organizations

Bristol-Myers Squibb Company, Summit, NJ, Bristol-Myers Squibb, Summit, NJ, Bristol Myers Squibb, Princeton, NJ, University of Arizona Cancer Center, Tucson, AZ

Research Funding

Pharmaceutical/Biotech Company
Bristol-Myers Squibb Company.

Background: Non-Hodgkin lymphoma comprises a heterogenous group of hematologic malignancies, including aggressive lymphomas such as DLBCL. Novel treatment modalities include CAR T cell therapies. Limited real-world data exist on HCRU and costs among pts treated with FDA-approved CAR T cell therapies. Methods: Pts with DLBCL treated with CAR T cell therapies were identified in 4 databases (IBM MarketScan, n = 60; Optum Clinformatics, n = 56; PharMetrics Plus, n = 75; and Humana, n = 14) from September 2017–H2 2019. Mean total, inpatient, outpatient, and pharmacy costs were calculated and adjusted to 2019 US dollars. HCRU and costs were stratified by adverse events (AEs) of interest—cytokine release syndrome (CRS) and neurological events (NEs)—identified through unvalidated “loose” and “strict” criteria. Results: A total of 205 pts were identified. Across databases, mean age ranged from 55.2–68.9 years, 63%−86% were male, and 88%−100% received CAR T cell therapy in the inpatient setting. In the 3 months after CAR+ T cell infusion, mean TCOC for all pts ranged from $353,642−$525,772 across databases (Table); mean TCOC were highest among pts who had CRS ($344,486−$730,224; strict CRS criteria). Mean inpatient length of stay (LOS) ranged from 17−21 days and was longer among pts who had CRS (18−23 days; n = 62) or NEs (20−24 days; n = 89) (strict CRS/NE criteria). Conclusions: HCRU and TCOC among pts with DLBCL treated with CAR T cell therapies were generally higher among pts who experienced CRS or NEs. Payors and health care systems may benefit from considering the total cost of CAR T cell therapy, including HCRU associated with treatment-emergent AEs.

VariableClinformatics
(n = 56)
Humana
(n = 14)
MarketScan
(n = 60)
PharMetrics
(n = 75)
Costs, mean
Total$353,642$395,648$525,772$453,490
Inpatient$236,135$384,809$486,533$363,540
Outpatient$112,285$9,897$36,071$86,525
Pharmacy$5,222$942$3,169$3,425
CRS, n (%)
Loose criteria47 (84)13 (93)45 (75)63 (84)
Strict criteria29 (52)6 (43)21 (35)46 (61)
Severe CRS, n (%)12 (21)2 (14)9 (15)24 (32)
NE, n (%)
Loose criteria38 (68)12 (86)35 (58)52 (69)
Strict criteria23 (41)10 (71)18 (30)38 (51)
Severe NE, n (%)17 (30)9 (64)15 (25)32 (43)
Inpatient LOS, d
Mean21171721
Median (range)16 (1–91)16 (1–48)14 (1–65)17 (2–69)
Subsequent therapy after
CAR T cell therapy
Received, n (%)16 (29)3 (21)16 (27)21 (28)
Median time to next treatment, d98106104107

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Abstract Details

Meeting

2020 ASCO Quality Care Symposium

Session Type

Poster Session

Session Title

On-Demand Poster Session: Cost, Value, and Policy

Track

Cost, Value, and Policy

Sub Track

Value/Cost of Care

Citation

J Clin Oncol 38, 2020 (suppl 29; abstr 76)

DOI

10.1200/JCO.2020.38.29_suppl.76

Abstract #

76

Poster Bd #

Online Only

Abstract Disclosures

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