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Treatment patterns, adverse events, healthcare resource use and costs among commercially insured patients with mantle cell lymphoma in the United States

INTRODUCTION: There are limited data on treatment patterns, adverse events (AEs), and economic burden in younger, commercially insured patients treated for mantle cell lymphoma (MCL). METHODS: Adults with ≥1 treatment for MCL between 1 November 2013‐31 December 2017 were identified from IQVIA Real‐W...

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Autores principales: Kabadi, Shaum M., Near, Aimee, Wada, Keiko, Burudpakdee, Chakkarin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6885896/
https://www.ncbi.nlm.nih.gov/pubmed/31595715
http://dx.doi.org/10.1002/cam4.2559
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author Kabadi, Shaum M.
Near, Aimee
Wada, Keiko
Burudpakdee, Chakkarin
author_facet Kabadi, Shaum M.
Near, Aimee
Wada, Keiko
Burudpakdee, Chakkarin
author_sort Kabadi, Shaum M.
collection PubMed
description INTRODUCTION: There are limited data on treatment patterns, adverse events (AEs), and economic burden in younger, commercially insured patients treated for mantle cell lymphoma (MCL). METHODS: Adults with ≥1 treatment for MCL between 1 November 2013‐31 December 2017 were identified from IQVIA Real‐World Data Adjudicated Claims‐US; index date was first treatment. Patients carried ≥1 MCL diagnosis, were newly treated, and were enrolled continuously for ≥12 months prior to and ≥30 days following index. Patients receiving the four most common MCL regimens were included. Measures included frequency of incident AEs, resource use, and costs overall and by number of AEs. Adjusted logistic regression and generalized linear modeling evaluated risk of hospitalization and all‐cause costs per patient per month (PPPM). RESULTS: Two thousand five hundred and nine treated patients had a drug‐specific code and were classified to a specific treatment regimen. Of those patients, 1785 patients received at least one of the four most commonly used MCL regimens (R‐CHOP, rituximab monotherapy, B‐R, and ibrutinib) at some point over follow‐up (median 23 months). R‐CHOP was the most common regimen observed in the first line (26%), followed by rituximab monotherapy (19%), B‐R (15%), and ibrutinib (5%). The median age was 57 years; median Charlson Comorbidity Index was 0. Among patients receiving the four most common regimens, 63% of patients experienced ≥1 incident AE (R‐CHOP 77%, B‐R 58%, and ibrutinib 52%). An increasing number of incident AEs was associated with increased hospitalization risk (odds ratio = 2.4; 95% Confidence Interval [CI] 2.1‐2.7) and increased mean costs PPPM (cost ratio = 1.1; 95% CI 1.1‐1.2). DISCUSSION: This is the largest study describing treatment patterns and clinical and economic impact of MCL treatment. The most common regimens were R‐CHOP, rituximab monotherapy, B‐R, and ibrutinib. The majority of treated patients experienced at least one incident AE, with hospitalization risk and all‐cause costs increasing as the number of AEs increased.
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spelling pubmed-68858962019-12-09 Treatment patterns, adverse events, healthcare resource use and costs among commercially insured patients with mantle cell lymphoma in the United States Kabadi, Shaum M. Near, Aimee Wada, Keiko Burudpakdee, Chakkarin Cancer Med Clinical Cancer Research INTRODUCTION: There are limited data on treatment patterns, adverse events (AEs), and economic burden in younger, commercially insured patients treated for mantle cell lymphoma (MCL). METHODS: Adults with ≥1 treatment for MCL between 1 November 2013‐31 December 2017 were identified from IQVIA Real‐World Data Adjudicated Claims‐US; index date was first treatment. Patients carried ≥1 MCL diagnosis, were newly treated, and were enrolled continuously for ≥12 months prior to and ≥30 days following index. Patients receiving the four most common MCL regimens were included. Measures included frequency of incident AEs, resource use, and costs overall and by number of AEs. Adjusted logistic regression and generalized linear modeling evaluated risk of hospitalization and all‐cause costs per patient per month (PPPM). RESULTS: Two thousand five hundred and nine treated patients had a drug‐specific code and were classified to a specific treatment regimen. Of those patients, 1785 patients received at least one of the four most commonly used MCL regimens (R‐CHOP, rituximab monotherapy, B‐R, and ibrutinib) at some point over follow‐up (median 23 months). R‐CHOP was the most common regimen observed in the first line (26%), followed by rituximab monotherapy (19%), B‐R (15%), and ibrutinib (5%). The median age was 57 years; median Charlson Comorbidity Index was 0. Among patients receiving the four most common regimens, 63% of patients experienced ≥1 incident AE (R‐CHOP 77%, B‐R 58%, and ibrutinib 52%). An increasing number of incident AEs was associated with increased hospitalization risk (odds ratio = 2.4; 95% Confidence Interval [CI] 2.1‐2.7) and increased mean costs PPPM (cost ratio = 1.1; 95% CI 1.1‐1.2). DISCUSSION: This is the largest study describing treatment patterns and clinical and economic impact of MCL treatment. The most common regimens were R‐CHOP, rituximab monotherapy, B‐R, and ibrutinib. The majority of treated patients experienced at least one incident AE, with hospitalization risk and all‐cause costs increasing as the number of AEs increased. John Wiley and Sons Inc. 2019-10-08 /pmc/articles/PMC6885896/ /pubmed/31595715 http://dx.doi.org/10.1002/cam4.2559 Text en © 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Cancer Research
Kabadi, Shaum M.
Near, Aimee
Wada, Keiko
Burudpakdee, Chakkarin
Treatment patterns, adverse events, healthcare resource use and costs among commercially insured patients with mantle cell lymphoma in the United States
title Treatment patterns, adverse events, healthcare resource use and costs among commercially insured patients with mantle cell lymphoma in the United States
title_full Treatment patterns, adverse events, healthcare resource use and costs among commercially insured patients with mantle cell lymphoma in the United States
title_fullStr Treatment patterns, adverse events, healthcare resource use and costs among commercially insured patients with mantle cell lymphoma in the United States
title_full_unstemmed Treatment patterns, adverse events, healthcare resource use and costs among commercially insured patients with mantle cell lymphoma in the United States
title_short Treatment patterns, adverse events, healthcare resource use and costs among commercially insured patients with mantle cell lymphoma in the United States
title_sort treatment patterns, adverse events, healthcare resource use and costs among commercially insured patients with mantle cell lymphoma in the united states
topic Clinical Cancer Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6885896/
https://www.ncbi.nlm.nih.gov/pubmed/31595715
http://dx.doi.org/10.1002/cam4.2559
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