Researchers recently compared health care resource utilization (HRU) and costs of relapsed or refractory (R/R) mantle cell lymphoma (MCL) patients treated with ibrutinib ± rituximab (I±R) or chemoimmunotherapy (CIT) in a US-managed care population.
This study by Nilanjan Ghosh, PhD, MD, Atrium Health (Charlotte, NC), and colleagues is to be presented at the 2020 American Society of Clinical Oncology (ASCO) Virtual Scientific Program (May 29-31, 2020).
Adults with MCL receiving I±R or CIT (index date) following at least 1 prior line of therapy (LOT) between May 13, 2013 and June 30, 2019, were identified through the Optum Clinformatics Extended DataMart De-Identified Databases. Baseline characteristics were balanced using inverse probability of treatment weighting. Monthly HRU and costs (plan paid amount) were evaluated during the first Oncology Care Model (OCM) episode (ie, the first 6 months) post-index and during the observed index I±R or CIT LOT (index LOT); and compared using rate ratios (RRs) and mean monthly cost differences (MMCDs), respectively.
In total, 146 I±R and 158 CIT patients were identified. Two patients with total health care costs ≤ 0.5th and ≥ 99.5th percentile were excluded from each cohort given the small sample size and to make sure outliers were not driving results. After IPTW, 149 and 151 patients were included in the weighted I±R and CIT cohorts, respectively (mean length of index LOT: 12.0 vs 11.0 months).
During the first OCM episode and during the index LOT, the I±R cohort had significantly fewer monthly days with outpatient services compared with the CIT cohort (OCM: RR = 0.63, P < .001; index LOT: RR = 0.73, P = .004). The I±R cohort incurred significantly higher monthly pharmacy costs that were offset by lower monthly medical costs, yielding a monthly total cost reduction of $9435 (P < .001) during the first OCM episode and $4628 (P = .010) during the index LOT, compared with the CIT cohort.
Based on these results, authors concluded that patients with R/R MCL treated with ibrutinib ± rituximab had significantly fewer days with outpatient services and lower total health care costs per month vs those treated with CIT during the first OCM episode and the index LOT.—Amanda Del Signore
