What are the health care costs for chronic lymphocytic leukemia?

• Published in: Journal of clinical oncology Vol. 35; no. 8_suppl; p. 15
• Main Authors: Matasar, Matthew J., DaCosta Byfield, Stacey, Blauer-Peterson, Cori, Montez, Melissa, Reyes, Carolina, Masaquel, Anthony
• Format: Journal Article
• Language: English
• Published: 10.03.2017
• ISSN: 0732-183X; 1527-7755
• DOI: 10.1200/JCO.2017.35.8_suppl.15

Abstract only 15 Background: New drugs for chronic lymphocytic leukemia (CLL) have recently been approved, including oral therapies. We examined total health care costs, including drug and patient out-of-pocket (OOP) costs, in patients (pts) initiating CLL treatment. Methods: This retrospective studyused a U.S. health insurance claims database. Adult commercially insured and Medicare Advantage pts from 5/2013 - 6/2015, with ≥2 medical claims for CLL were included. Pts required ≥1 claim for NCCN-recommended systemic cancer therapy. Pts were categorized based on first-line of therapy. Aggregate costs during a fixed 9-month follow-up period (treatment switch or discontinuation were possible) were investigated. Mean and standard deviation (SD) of total healthcare costs, regimen costs, and pt OOP regimen costs are presented. Results: A total of 707 CLL pts met all study criteria during the study period; 40% were commercially insured and 60% had Medicare Advantage. Mean age was 70 years (SD 11). Some of the most common regimens received included Bendamustine+Rituximab (BR) (N=186), Ibrutinib (Ibr) (N=101), Fludarabine, Cyclophosphamide, and Rituximab (FCR) (N=62), and Obinutuzumab +/- Chlorambucil (Ob+/-Chl) (N=51). Mean length of therapy varied by regimen; BR 4.2 months (m) (SD 2.7), Ibr 6.7m (SD 4.8), FCR 4.7m (SD 2.1), and Ob±Chl 4.0m (SD 2.1). The table shows aggregate costs among pts with ≥ 9 months follow-up. Ob±Chl had lower costs compared to other cohorts. Ibr had the highest drug costs. Conclusions: While the study has limited follow-up, Ob+/-Cl had the lowest drug and total costs. Oral therapy with Ibr had the highest drug and OOP costs compared to those associated with a prescribed fixed number of cycles. The magnitude of the difference between orals and infusions is expected to be greater with a longer follow-up and is a consideration in patient treatment decision-making in CLL.[Table: see text]