Meeting
2021 ASCO Annual Meeting
Resource use and costs in patients with relapsed/refractory diffuse large C-cell lymphoma who initiated a third-line therapy in the post CAR-T era: A longitudinal outlook.
Authors
Lei Chen
ADC Therapeutics, Inc., New Providence, NJ
Lei Chen , Jipan Xie , Aozhou Wu , Laura Liao , Ella X. Du , Ahmed Noman , Loretta J. Nastoupil
Organizations
ADC Therapeutics, Inc., New Providence, NJ, Analysis Group, Inc., Los Angeles, CA, Analysis Group, Inc, Los Angeles, CA, The University of Texas MD Anderson Cancer Center, Department of Lymphoma/Myeloma, Houston, TX
Research Funding
Pharmaceutical/Biotech Company
ADC Therapeutics, Inc
Background: The study described longitudinal costs and healthcare resource utilization (HRU) associated with third-line (3L) treatments in patients with relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL) post chimeric antigen receptor T-cell (CAR-T) approval. Methods: Adult patients newly diagnosed with DLBCL (ICD-10: C83.3) from 10/01/2015 to 03/31/2020 and receiving 3L after CAR-T approval (10/18/2017) were identified from IQVIA PharMetrics Plus. Monthly HRU and total costs were evaluated during month 1, months 2-6, and months 7-12 following 3L initiation for three treatment groups: CAR-T, stem cell transplantation (SCT), and non-cell therapy including chemoimmunotherapy and the targeted therapies that are recommended by the NCCN guidelines (including brentuximab vedotin, ibrutinib, venetoclax, lenalidomide, polatuzumab, obinutuzumab, nivolumab and pembrolizumab). Results: The study identified 145 R/R DLBCL patients initiating 3L with a mean age of 56.7 years and 66.2% male; 135 patients with ≥1 month of follow-up (median 6.7 months) were included: 24 CAR-T, 15 SCT, 96 non-cell therapy. At each time period, CAR-T had the highest median monthly costs, followed by SCT; both had higher median costs than non-cell therapy. The median monthly costs for CAR-T and SCT were $205,034 and $160,423 in month 1, and reduced to $14,333 and $11,840 in months 2-6, then increased to $27,090 and $17,695 in months 7-12, respectively. The monthly median cost for non-cell therapy was $36,015, $11,878, and $4,806 in month 1, months 2-6 and 7-12, respectively. Inpatient (IP) visits and IP days were higher in month 1 than later months for CAR-T and SCT. In addition, outpatient (OP) and emergency room (ER) visits were more frequent for CAR-T than SCT except for ER visits in month 1 (Table). Conclusions: In R/R DLBCL patients receiving 3L, CAR-T had the highest median monthly costs during month 1, months 2-6 and 7-12. In addition, CAR-T has more frequent OP and ER visits compared with SCT in general.
| Monthly HRU | Month after CAR-T Infusion | Month after SCT Infusion | ||||
|---|---|---|---|---|---|---|
| M 1 | M 2-6 | M 7-12 | M 1 | M 2-6 | M 7-81 | |
| Number of patients | 24 | 21 | 14 | 15 | 14 | 5 |
| Patients with IP visits, n (%) | 20 (83.3%) | 12 (57.1%) | 7 (50%) | 11 (73.3%) | 7 (50%) | 2 (40%) |
| IP days, mean (SD) | 14.1 (9.9) | 1.4 (1.7) | 2.4 (3.4) | 14.8 (12.5) | 1.9 (2.3) | 2.3 (3.7) |
| Patients with OP visits, n (%) | 21 (87.5%) | 21 (100%) | 14 (100%) | 9 (60%) | 11 (78.6%) | 4 (80%) |
| Number of OP visits, mean (SD) | 6.5 (6.3) | 5.8 (3.4) | 5.7 (4.9) | 3.3 (6.0) | 3.9 (4.2) | 4.9 (6.9) |
| Patients with ER visits, n (%) | 3 (12.5%) | 8 (38.1%) | 4 (28.6%) | 2 (13.3%) | 2 (14.3%) | 0 (0%) |
| Patients with other visits2, n (%) | 4 (16.7%) | 8 (38.1%) | 5 (35.7%) | 2 (13.3%) | 4 (28.6%) | 2 (40%) |
The maximum observed follow-up time for SCT was 8 months.
Other visits were mainly home care visits.
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Abstract Details
Session Type
Publication Only
Session Title
Publication Only: Hematologic Malignancies—Lymphoma and Chronic Lymphocytic Leukemia
Track
Hematologic Malignancies
Sub Track
Non-Hodgkin Lymphoma
Citation
J Clin Oncol 39, 2021 (suppl 15; abstr e19560)
DOI
10.1200/JCO.2021.39.15_suppl.e19560
Abstract #
e19560
Abstract Disclosures
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