reatment Patterns and Health Care Costs in Commercially Insured Patients with Follicular Lymphoma

Fowler, Nathan; Chen, Guifang; Lim, Stephen; Manson, Stephanie; Ma, Qisheng; Li, Frank Yunfeng

doi:10.36469/jheor.2020.16784

Cited by 11 publications

(14 citation statements)

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“…Continued disease burden and high healthcare cost is, unfortunately, a familiar issue in the US. Real world data on treatment patterns and HCRU show high burden and high cost for a wide range of diseases [33][34][35], and while the development of new MG treatment options is therefore of benefit, they are unlikely to fully resolve the issues identified in our study.…”

Section: Discussionmentioning

confidence: 83%

Physician-Reported Perspectives on Myasthenia Gravis in the United States: A Real-World Survey

et al. 2022

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Introduction: Myasthenia gravis (MG) is a rare, debilitating, chronic disorder caused by the production of pathogenic immunoglobulin G autoantibodies against the neuromuscular junction. A lack of real-world studies in rare diseases reflects a relatively limited understanding of the significant unmet needs and burden of disease for patients. We aimed to provide comprehensive real-world insights into the management and burden of MG from treating physicians in the United States (US). Methods: Data were collected using the Adelphi Real World MG Disease Specific Programme TM , a point-in-time survey of physicians and their patients with MG, in the US between March and July 2020. Physician-reported clinical data, including demographics, comorbidities, symptoms, disease history, treatments, and healthcare resource utilization, were collected. Results: In total, 456 patient record forms were completed by 78 physicians based in the US. At time of survey completion, patient mean age was 54.5 years. Mean time from symptom onset to diagnosis was 9.0 months (n = 357). Ocular symptoms were reported in 71.7% of patients. General fatigue affected 47.1% of patients and over half of those reported the severity as moderate or severe (59.5%, n = 128). Acetylcholinesterase inhibitors and/or steroids were the most frequently prescribed first-line treatment type among patients receiving treatment at time of survey completion and with moderate-to-severe symptoms (77.9%, n = 159/204). High-dose steroids (n = 14) and intravenous immunoglobulin (n = 13) were the most prescribed acute treatments among those receiving an acute treatment at time of survey completion (n = 36), with symptom exacerbations or myasthenic crises being the most common reasons for acute treatment. On average, 2.5 healthcare professionals were involved in patient management and 5.0 consultations were made per patient over the last 12 months. Conclusions: Our findings indicated that, despite treatment, there is a proportion of patients with MG in the US who had a significant need for improved disease management.

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Section: Discussionmentioning

confidence: 83%

Physician-Reported Perspectives on Myasthenia Gravis in the United States: A Real-World Survey

et al. 2022

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“…Simultaneously, the costs of drugs to treat cancer are rising faster than all other drugs in the United States 8 . Annualized treatment costs between 2010 and 2013 for follicular lymphoma, a common non‐Hodgkin lymphoma, approached $100,000 for first‐line therapy and exceeded $400,000 for fifth‐line therapy 9 . Systemic therapy for Hodgkin lymphoma exceeds $100,000 per person per year 10 .…”

Section: Figurementioning

confidence: 99%

“…8 Annualized treatment costs between 2010 and 2013 for follicular lymphoma, a common non-Hodgkin lymphoma, approached $100,000 for first-line therapy and exceeded $400,000 for fifth-line therapy. 9 Systemic therapy for Hodgkin lymphoma exceeds $100,000 per person per year. 10 Similarly high costs exist for the treatment of anal cancer.…”

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confidence: 99%

An ounce of prevention: Medicaid's role in reducing the burden of cancer in men with HIV

Sabik

2022

Cancer

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One of the more remarkable joint public health and medical achievements of the past several decades is the decline in annual incident HIV cases (an 8% decrease between 2015 and 2019) 1 coupled with an improved survival period after HIV diagnosis that approaches the lifespan of the general population. 2 Although highly active antiretroviral treatment (HAART) is the primary reason survival has improved to previously unimagined longevity, people living with HIV (PLWH) often suffer from comorbid conditions that limit their ability to live their lives as they would have in the absence of HIV. PLWH are also more likely to be persons of color, men who have sex with men, transgender women, people who inject drugs, and people with lower socioeconomic status. Given the complex clinical, patient, social, and health care system factors that affect health risks, access to care, and care coordination for PLWH, it is essential to understand patterns of serious and high-cost comorbid conditions to inform strategies for prevention and management among providers, health care payers, and policymakers.In this issue of Cancer, Koroukian et al report excess cancer in men living with HIV (MLWH) and insured by Medicaid. 3 Strikingly, the prevalence of cancer was nearly twice as high in MLWH as in men without a diagnosis of HIV. In this national sample of MLWH, lymphoma and anal cancer were the most prevalent cancers, although MLWH also had an excess prevalence of other cancers, including cancers of the esophagus and rectum, as well as a higher prevalence of leukemia, relative to a sample of men without HIV. This finding underscores the need to better understand risk factors among PLWH so that cancer can be prevented and, if not prevented, detected early, when treatment is most effective. The findings also draw attention to the experiences of a growing survivorship population, one that lives with both HIV and cancer.Koroukian and colleagues' study sample was drawn from the national Medicaid Analytic eXtract file, which includes data from fee-for-service plans and health maintenance organizations. This is a highly relevant sample to study because Medicaid provides health insurance coverage for approximately 42% of PLWH 4 who, in all likelihood, will age into Medicare coverage if they do not qualify as dually eligible for both programs before age 65 years. Together, federal funding for HIV/AIDS care under the Medicaid and Medicare programs was >$17 billion in 2019. 4 By using Medicaid claims data, the researchers used International Classification of Diseases, Ninth Revision, diagnosis codes to identify HIV status and 13 common cancers. They further stratified the sample by symptomatic and asymptomatic HIV, age, and race/ethnicity to examine differences within these important subgroups who may disproportionately experience adverse effects of HIV and cancer and who also may face inequities in receipt of health care. The burden of cancer was not shared equally across the sample of MLWH. Hispanic men, a group that is relatively understudied,...

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“…9 Real-world data evaluating treatment patterns in follicular lymphoma estimated 5-42% of patients receive second-line and beyond therapy, [30][31][32] with a range of 6-26% receiving BND as part of this therapy. [30][31][32][33] The model assumed these patients progressed during or within six months of treatment with rituximab or a rituximab-based regimen, per the BND US prescribing information (USPI), and may also be receiving BND treatment beyond second-line, increasing the patient count potentially receiving BND in a given year. Using the second-line follicular lymphoma treatment patterns as a low-estimate proxy for those of iNHL, the model assumed 50% of patients with iNHL receive second-line or beyond at any given time, and 30% of those patients receive BND.…”

Section: Eligible Populationmentioning

confidence: 99%

Budgetary Impact of Bendamustine Ready-to-Dilute Products in Chronic Lymphocytic Leukemia and Non-Hodgkin Lymphoma to a United States Infusion Facility

James¹,

Trautman²,

Thompson

et al. 2021

CEOR

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Background: Bendamustine hydrochloride (BND HCl) is indicated for first-line treatment of chronic lymphocytic leukemia (CLL) and rituximab-refractory indolent non-Hodgkin lymphoma (iNHL). There are two ready-to-dilute (RTD) formulations of BND HCl on the US market: a largevolume, long-duration infusion (BND-L) and a small-volume, short-duration infusion (BND-S). It is estimated that the shorter duration infusion could result in cost savings to infusion facilities. Objective: Estimate the one-year budget impact between BND-S and BND-L for use in the treatment of CLL and iNHL when all current BND-L utilization is replaced with BND-S, from the US infusion facility perspective. Methods: An illustrative budget impact model estimated the change in costs associated with a projected increase from 50% to 100% market share for BND-S. The model included CLL and iNHL patient populations. Budgetary costs reflected facility expenditures on drug acquisition and administration based on recommended dosing for BND-S and BND-L. The base-case model assumptions and inputs were derived from scientific literature and publicly available resources. The total budget impact was calculated annually, along with the differences in per patient cost; one-way sensitivity analyses were conducted. Results: Per-patient savings with BND-S use after the utilization shift were estimated at $2812.24 for CLL and $4769.01 for iNHL. Across both indications, the total annual incremental savings after the utilization shift were estimated at $452,209 for 250 CLL and iNHL patients in a 10,000-patient infusion facility, resulting in cost savings of $150.74 per BND HCI patient per month and $1808.84 per BND HCI patient per year. The model was sensitive to changes in proportion of patients receiving BND HCI infusions for CLL and iNHL, patient body surface area, and BND-S wholesale acquisition cost. Conclusion: This analysis estimated over $450,000 in annual savings for a 10,000-patient chemotherapy infusion facility following a utilization shift from 50% use of each RTD product to 100% use of BND-S in CLL and iNHL patients, driven by lower acquisition costs for BND-S and lower administration labor costs associated with rapid infusion.

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reatment Patterns and Health Care Costs in Commercially Insured Patients with Follicular Lymphoma

Cited by 11 publications

References 55 publications

Physician-Reported Perspectives on Myasthenia Gravis in the United States: A Real-World Survey

Physician-Reported Perspectives on Myasthenia Gravis in the United States: A Real-World Survey

An ounce of prevention: Medicaid's role in reducing the burden of cancer in men with HIV

Budgetary Impact of Bendamustine Ready-to-Dilute Products in Chronic Lymphocytic Leukemia and Non-Hodgkin Lymphoma to a United States Infusion Facility

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