Real-World Evaluation of Treatment Pattern, Time to Next Treatment,
Healthcare Resource Utilization, and Cost of Care in Follicular Lymphoma

P1124

Sameh R. Gaballa,1 Mei Xue,2 Po-Ya Chuang,3 Kaitlyn Esselman,3 Wesley Furnback,3 Keri Yang2
1Moffitt Cancer Center, Tampa, FL, USA; 2BeiGene, USA, San Mateo, CA, USA; 3Real Chemistry, New York, NY, USA

IN T R O D U CT I ON

RE SU LTS

• Follicular lymphoma (FL) is the most common indolent non-Hodgkin lymphoma,

Study Population (Table 1)

accounting for nearly one-quarter of all non-Hodgkin lymphoma cases1• An estimated 20% of individuals with FL will experience disease progression
within 24 months of first-line therapy2,3 and be subject to less favorable
clinical outcomes4,5

OBJ E C T I VE

• This study aimed to understand treatment utilization, treatment patterns, timeto next treatment (TTNT), healthcare resource utilization (HCRU), and cost ofcare in FL in the United States

C O N C LU SI O N SFigure 1. Treatment Utilization by Line of Therapy• A total of 4525 patients initiated first-line (1L) treatment– Number of patients who initiated second-, third-, and fourth-line (2L, 3L, and 4L)
treatments were 1053, 304, and 97, respectively• Median follow-up for 1L treatment was 487 days
– Median follow-up for 2L, 3L, and 4L treatments were 430 days, 357 days, and• The mean age at index was similar across cohorts (range: 69.6 [1L] to 71.9
[4L] years)

ME T HODS• Data was sourced from Optum® Clinformatics® Data Mart, a comprehensive,increased with each subsequent line of treatment, indicating a high disease
burden in patients with FL, particularly for those with refractory/relapsed FL• These findings suggest the need for better treatment options forpatients with FL, especially in 3L and 4L

2% 2%IL(n=4525)

27%

32%

22%

5%

10%

1%

2L
(n=1053)

18%

24%

13%

6%

8%

29%

276 days, respectively

Characteristic

1L(n=4525)

2L(n=1053)3L(n=304)

Table 2. Mean (SD) HCRU and Cost of Care, PPPM, by Line of Therapy

2%3L(n=304)

15%

16%

11%

5%

42%

9%

12%

4L
(n=97)

12%

0%

6%

20%

BRR2Sex, n (%)

8%4%

Male

2269 (50.1%)559 (53.1%)

177 (58.2%)

40%

R-monoO-mono

60%

80%

100%

R-CHOPBO
Other treatments

63 (65.0%)

TTNT (Figure 2)

34 (35.1%)• The median TTNT across all regimens decreased by line of therapy• BO demonstrated the longest TTNT in 1L (median TTNT=679 days)• BR (median TTNT=367 days) followed by R-mono (median TTNT=348 days)

index period of January 1 to February 28, 2023

• Inclusion criteria included patients aged ≥18 years who had undergone at least
1 line of treatment (≥1L) for FL during the index period• Eligible patients had continuous enrollment in the database for 30 days pre- andpostindex dateCohorts• Patients were categorized into mutually exclusive cohorts basedon the following treatment regimens:– Bendamustine + rituximab (BR)– Rituximab monotherapy (R-mono)– Cyclophosphamide, doxorubicin, prednisone, rituximab + vincristine (R-CHOP)– Bendamustine + obinutuzumab (BO)
– Lenalidomide + rituximab (LR)– Obinutuzumab monotherapy (O-mono)– Chimeric antigen receptor T-cell therapy (CAR-T)– Other treatment regimens

Study Measures

2256 (49.9%)494 (46.9%)

127 (41.8%)

Age at index
Mean (SD), years
Median (IQR),years
65+, n (%)

demonstrated the longest TTNT in 2L
69.6 (11.8)
71 (64, 78)
3342 (73.9%)

70.9 (11.3)
73 (65, 79)794 (75.4%)

70.5 (11.3)
72 (64, 79)
227 (74.7%)• TTNT was measured for patients who had a subsequent treatment within thestudy period• Total cost of care included costs incurred from– Outpatients visits– Inpatient admissions– Emergency room visits– Pharmacy– Other/ancilliary services• HCRU and costs are reported as per patient per month (PPPM)• Costs were inflated to reflect USD 2023

Inpatient admissions

0.1 (0.32)

0.14 (0.38)

0.28 (0.56)

0.27 (0.44)

Outpatient visits5.32 (3.16)

5.77 (3.73)

6.29 (3.95)

6.05 (3.32)

Emergency room visits

0.17 (0.46)

0.18 (0.45)

0.36 (0.85)

0.37 (0.64)

Other ancillary services

0.71 (1.38)

0.84 (2.17)

1.06 (2.93)

0.71 (2.09)

Costs*, USD, mean (SD) PPPM
Inpatient admissions

6419(31566)15609(66183)28595(81501)30000(81333)Outpatient visits

32073(29927)31434(41735)39329(68262)30622(42427)73 (63, 80)• R-mono demonstrated the longest TTNT in 4L (median TTNT=553 days)

Emergency room visits392(1981)

360(1366)

661(1887)

646(1235)

72 (74.2%)

Figure 2. TTNT by Treatment and Line of Therapy

Other ancillary services

154(1762)

290(3992)

366(2476)

238(1872)

Pharmacy

1500(4868)

4077(7606)

5514(9228)

6243(8899)

Non-pharmacy

39038(42851)47694(77527)68952(107674)61505(89055)400

Total Costs, PPPM

40538
(42688)51771(76805)74466(106649)67748(88691)300* Costs are inflation-adjusted USD.

demonstrated the longest TTNT in 3L

800

Payer type, n (%)
MedicareCommercial

700

3360 (74.3%)
1164 (25.7%)795 (75.5%)
258 (24.5%)

220 (72.4%)
84 (27.6%)

72 (74.2%)
25 (25.8%)

CCI
Mean (SD)7.52 (3.22)

7.27 (3.43)

7.63 (3.48)

7.54 (2.79)

600
500

200
1000

Median (IQR)8 (8, 9)

8 (8, 9)8 (8, 9)8 (8, 8)

Note: One patient within 1L had an unknown insurance status.
CCI, Charlson Comorbidity Index; IQR, interquartile range; SD, standard deviation.

REFERENCES
1L

2L

3L

4L

Line of Therapy
All regimens
BOBR
LR

R-monoO-monoR-CHOP
Other treatments• HCRU included outpatient visits and inpatient admissions, which weremeasured during the 365-day follow-up period

4L(n=97)

71.9 (10.7)• Demographics, clinical characteristics, and treatment regimens wereexamined for each line of therapy cohort

3L(n=304)• LR (median TTNT=499 days) followed by BR (median TTNT=448 days)

Median TTNT, days

Inclusion CriteriaFemale

2L(n=1053)

HCRU, mean (SD) PPPM

56%

longitudinal, closed-claims database• The study period was from December 1, 2018 to March 31, 2023 with an

1L(n=4525)

1%

4L(n=97)

Table 1. Baseline Demographics and Clinical Characteristics

Data Source• This real-world study showed that TTNT decreased while costs and HCRU

Treatment Patterns (Figure 1)

HCRU and Cost of Care (Table 2)• R-mono was the most utilized treatment in 1L, 2L, and 3L followed by BR• Inpatient admissions and outpatient visits increased with the line of therapy– Mean (SD) inpatient admissions ranged from 0.1 (0.3) in 1L to 0.3 (0.4) in 4L– Mean (SD) outpatient visits were 5.3 (3.2) in 1L, 5.8 (3.7) in 2L, 6.3 (4.0) inand R-CHOP• In 4L, BR and R-mono were the most commonly used therapies followedby R-CHOP• O-mono use increased by line of therapy• Other treatments increased with each line of therapy, from 10% in 1L to 56% in 4L

3L, and 6.1 (3.3) in 4L– R-mono had the lowest while R-CHOP had the highest mean outpatient
visits across lines of therapy• The mean total cost of care ranged from $40,538 to $74,466, increasing byline of therapy• The mean total cost of care was consistently lowest in R-mono ($31,704 to$36,197), while CAR-T had the highest total cost ($501,493 to $522,378)

1. Perry AM, et al. Haematologica. 2016;101(10):1244-1250.
2. Batlevi CL, et al. Blood Cancer J. 2020;10(7):74.
3. Cahill KE, Smith SM. Oncology (Williston Park). 2022;36(2):97-106.
4. Federico M, et al. J Clin Oncol. 2009;27(27):4555-4562.
5. Salles G, et al. Lancet. 2011;377(9759):42-51.

DI SC LO SU R E S
SRG: Grants: IPSEN, Adaptive Biotechnologies. Consulting fees: Abbvie, ADC
Therapeutics. Honoraria: ADC, Eli Lilly. Participation in Data Safety Monitoring/
Advisory Board: BeiGene, IPSEN, Kite, TG Therapeutics, AstraZeneca, Genmab,Regeneron, ADC Therapuetics, Genetech. MX, KY: Employment: BeiGene
PYC, KE, WF: Employment: Real Chemistry

AC K N OW LE DGE M E N TS
This study was sponsored by BeiGene, Ltd. Editorial assistance was provided
by Real Chemistry, and supported by BeiGene.

Presented at ASCO 2024; May 31–June 4, 2024; Chicago, IL/Virtual Conference