ABCL-509 Healthcare Utilization and Costs in Chimeric Antigen Receptor T-Cell Therapy for B-Cell Lymphoma

Denlinger, Nathan; Huang, Ying; Braunstein, Zachary; Sigmund, Audrey M.; Bajwa, Amneet; Kapoor, Nilesh; Agyeman, Akwasi; Fisher, Scott S.; Purdin, Zebulun; Neal, Alison; Yucebay, Filiz; Roddy, Julianna; Brammer, Jonathan E.; William, Basem M.; Saad, Ayman; Penza, Sam; Voorhees, Timothy J.; Kittai, Adam; Lima, Marcos de; Vasu, Sumithira; Jaglowski, Samantha

doi:10.1016/s2152-2650(22)01544-0

Cited by 1 publication

(14 citation statements)

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“…Only one retrospective study did not report the specific location where it was conducted [68]. Eleven studies reported data on CAR-T administration in both outpatient and inpatient settings [26,[32][33][34][35][36][37][38][39][40][41][42][43][44][52][53][54]58,61,62,[64][65][66][67][68]. These publications were based on 5 clinical trials, namely OUTREACH [32][33][34][35][36][37][38], ELARA [66,67], PILOT [39][40][41], TRANSCEND NHL 001 [42][43][44], and TRANSFORM [64,65], where the choice of site of care for patients treated with CAR-T therapies was determined at the investigator's discretion, taking into consideration the perspectives of multiple stakeholders including healthcare providers, patients, and caregivers.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Only one clinical trial reported QoL in the patient groups of interest [38]. Five studies reported data on AEs, including CRS and neurologic toxicity [37,39,42,53,67]. Seven studies reported costs/reimbursement amounts associated with the administration of CAR-T in both settings [26,41,52,53,62,65,67].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Five studies reported data on AEs, including CRS and neurologic toxicity [37,39,42,53,67]. Seven studies reported costs/reimbursement amounts associated with the administration of CAR-T in both settings [26,41,52,53,62,65,67]. Ten studies reported data on HCRU [26,37,39,41,[52][53][54]62,67,68] in both settings while a further seven studies reported HCRU among patients who received CAR-T only in the outpatient setting [26,37,39,41,46,[52][53][54][55]57,59,60,[62][63][64]67,68].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Seven studies reported costs/reimbursement amounts associated with the administration of CAR-T in both settings [26,41,52,53,62,65,67]. Ten studies reported data on HCRU [26,37,39,41,[52][53][54]62,67,68] in both settings while a further seven studies reported HCRU among patients who received CAR-T only in the outpatient setting [26,37,39,41,46,[52][53][54][55]57,59,60,[62][63][64]67,68]. The distribution of age, sex, performance status, number of prior treatment lines, and other patient characteristics varied across the studies.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Of the six double-arm studies, five were considered of good quality (score > 6) and one of fair quality (score 5) (Table S6). Among the six single-arm studies, five were rated as good quality (score > 4) and one as fair quality (score 4) [26,41,45,[53][54][55]57,59,60,62,63,68].…”

Section: Quality Assessmentmentioning

confidence: 99%

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The Impact of Outpatient versus Inpatient Administration of CAR-T Therapies on Clinical, Economic, and Humanistic Outcomes in Patients with Hematological Cancer: A Systematic Literature Review

Hansen,

Liu,

Ranjan

et al. 2023

Cancers

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Although chimeric antigen receptor (CAR)-T cell therapies are typically administered in the inpatient setting, outpatient administration is rapidly expanding. However, there is limited summarized evidence comparing outcomes between outpatient and inpatient administration. This systematic literature review aims to compare the safety, efficacy, quality of life (QoL), costs, and healthcare resource utilization (HCRU) outcomes in patients with hematological cancer who are administered CAR-T therapy in an outpatient versus an inpatient setting. Publications (2016 or later) that reported the outcomes of interest in patients treated with a CAR-T therapy in both outpatient and inpatient settings, or only the outpatient setting, were reviewed. In total, 38 publications based on 21 studies were included. Safety findings suggested the comparable frequency of adverse events in the two settings. Eleven studies that reported data in both settings showed comparable response rates (80–82% in outpatient and 72–80% in inpatient). Improvements in the QoL were observed in both settings while costs associated with CAR-T therapy were lower in the outpatient setting. Although unplanned hospitalizations were higher in the outpatient cohort, overall HCRU was lower. Outpatient administration of CAR-T therapy appears to have comparable outcomes in safety, efficacy, and QoL to inpatient administration while reducing the economic burden.

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