Healthcare resource utilization and costs of chronic lymphocytic leukemia/small lymphocytic lymphoma patients who relapse or are refractory to ibrutinib
Creators: name: De Nigris, Enrico
name: Yang, Xiaoqin
name: Zanardo, Enrico
name: Lejeune, Dominique
name: Farooqui, Mohammed ZH
name: Gandra, Shravanthi R
name: Laliberté, François
Publisher: name: Taylor & Francis
Year: 2024
Subjects: subject: Medicine
subject: Pharmacology
subject: Cancer
subject: Science Policy
subject: Hematology
subject: Plant Biology
subject: FOS: Biological sciences

description: <b>Aim:</b> Evaluate healthcare resource utilization (HRU) and costs in chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) who relapsed or are refractory to (R/R) ibrutinib. <b>Methods:</b> All-cause and CLL/SLL-related HRU and healthcare costs were evaluated in adult patients with CLL/SLL who received ibrutinib (2/2014–3/2020) as single-agent or combination therapy and discontinued/switched to another antineoplastic agent (R/R) vs. all other (non-R/R) ibrutinib users. <b>Results:</b> Compared with the non-R/R patients (N = 919), R/R patients (N = 207) had higher all-cause HRU (inpatient, outpatient and emergency room visits; rate ratios [95% <i>CIs</i>]: 1.51 [1.38, 1.65]–1.92 [1.57, 2.37]; all P &lt; 0.001) and healthcare costs ($81,645 vs. $34,717; cost difference [95% CI] = $50,170 [$40,555, $61,383]; P &lt; 0.001). <b>Conclusion:</b> CLL/SLL patients who are R/R to ibrutinib bear a substantial economic burden. Ibrutinib is a drug often prescribed for chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL)–two similar types of blood cancer-that returns/does not show improvement after a previous treatment (i.e., to patients who relapse after/are refractory to [R/R] the treatment). CLL/SLL that is R/R to ibrutinib can be costly because patients are left with fewer options for treatment and their cancer is likely to worsen. Knowing how much medical services are used and their cost when treating CLL/SLL that is R/R to ibrutinib can help patients, doctors and policy makers make informed decisions. In this study, the authors compared the use of healthcare resources-which included visits to the hospital, emergency room and doctor's office–and associated costs between patients with CLL/SLL in the United States who were R/R to ibrutinib and those who were not (non-R/R patients). The study showed that healthcare resource use and CLL/SLL-related medical costs were approximately two-times higher in R/R patients than in non-R/R patients. Thus, there is a substantial economic burden associated with R/R CLL/SLL. Ibrutinib is a targeted therapy widely used for the treatment of chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL). Patients with CLL/SLL who relapse after or are refractory to (R/R) ibrutinib have a substantial economic burden because they have fewer treatment options and their cancer is likely to progress. There are limited data on the real-world economic burden of CLL/SLL patients who are R/R to ibrutinib. This study compared healthcare resource utilization and associated costs between patients with CLL/SLL who were R/R to ibrutinib (N = 207) and those who were not (non-R/R patients, N = 919) by analyzing data from 2014 to 2020 from a large US claim database. Use of healthcare resources (inpatient, outpatient and emergency room visits) was one and a half to two-times higher in R/R patients than in non-R/R patients (rate ratios [95% confidence intervals]: 1.51 [1.38, 1.65]-1.92 [1.57, 2.37]). R/R patients also had nearly three-times higher medical costs than non-R/R patients ($81,645 vs. $34,717; cost difference [95% CI] = $50,170 [$40,555, $61,383]). The results show that there is a substantial economic burden associated with R/R CLL/SLL in the healthcare system.