Costs of relapsed diffuse large B-cell lymphoma among Medicare patients

Leuk Lymphoma. 2018 Dec;59(12):2880-2887. doi: 10.1080/10428194.2018.1459613. Epub 2018 Jun 25.

Abstract

While health care costs can be considerable in individuals with diffuse large B-cell lymphoma (DLBCL), the degree to which health care expenditures vary following first-line treatment for non-relapsed versus relapsed DLBCL is unknown. Using 100% Medicare claims, we identified beneficiaries with DLBCL treated with first-line therapy between 1 January 2010 and 30 June 2014. We then compared health care expenditures of patients who received a second-line immunochemotherapy (relapse cohort) to those who did not begin a second-line therapy during follow-up (non-relapse cohort). After propensity score matching, the relapsed cohort incurred significantly higher health care costs ($6998 vs $3314 per month; p < .001), driven by inpatient ($2548 vs $1943 per month; p < .001) and outpatient office visit costs ($3581 vs $753 per month; p < .001). Our analysis confirms older adults with relapsed DLBCL incur higher medical costs and suggests improved first-line treatment would not only reduce the likelihood of relapse, but also contain health care costs.

Keywords: Costs; diffuse large B-cell lymphoma; relapse; treatment patterns.

Publication types

  • Comparative Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents, Immunological / economics
  • Antineoplastic Agents, Immunological / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / economics
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Cost of Illness*
  • Female
  • Health Care Costs / statistics & numerical data*
  • Hospitalization / economics
  • Hospitalization / statistics & numerical data
  • Humans
  • Insurance Claim Review / economics
  • Insurance Claim Review / statistics & numerical data
  • Lymphoma, Large B-Cell, Diffuse / drug therapy
  • Lymphoma, Large B-Cell, Diffuse / economics*
  • Male
  • Medicare / economics*
  • Medicare / statistics & numerical data
  • Neoplasm Recurrence, Local / drug therapy
  • Neoplasm Recurrence, Local / economics*
  • Neoplasm Recurrence, Local / prevention & control
  • Retrospective Studies
  • Treatment Outcome
  • United States

Substances

  • Antineoplastic Agents, Immunological