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Healthcare Resource Utilization and Associated Costs of German Patients with Diffuse Large B-Cell Lymphoma: A
Peter Borchmann1, Jan-Michel Heger1, Jörg Mahlich2,3
1Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), University of Cologne, Kerpener Str. 60, 50937, Cologne, Germany.
Insights
Healthcare costs for diffuse large B-cell lymphoma (DLBCL) patients in Germany are substantial, driven by hospitalizations and drug expenses. New cost-effective treatments are needed to manage the financial burden of this aggressive cancer.
Area of Science:
- Oncology
- Health Economics
- Epidemiology
Background:
- Diffuse large B-cell lymphoma (DLBCL) is the most prevalent form of non-Hodgkin's lymphoma.
- Increasing prevalence of DLBCL poses a significant disease burden.
- Limited data exists on healthcare resource utilization (HCRU) and costs for German DLBCL patients.
Purpose of the Study:
- To analyze healthcare resource utilization (HCRU) and associated costs in German patients diagnosed with DLBCL.
- To identify the primary cost drivers in DLBCL patient care.
- To inform the development of cost-effective therapeutic strategies for DLBCL.
Main Methods:
- Utilized a large German statutory health insurance claims database (6.7 million enrollees).
- Identified incident DLBCL patients diagnosed between 2011 and 2018.
- Collected HCRU and cost data, analyzing per-patient-per-month (PPPM) costs across treatment lines.
Main Results:
- Analyzed 2495 DLBCL patients with an average follow-up of 41.7 months.
- Patients experienced increased hospitalizations (5.24 days/month overall, up to 9.4 days/month during treatment) and PPPM costs (€3695 post-diagnosis vs. €421 pre-diagnosis).
- First-line treatment PPPM costs reached €17,170, with hospitalizations (71%) and drug acquisition (18%) as main cost drivers.
Conclusions:
- The financial burden of DLBCL in Germany is significant, primarily due to hospitalization and medication expenses.
- There is a critical need for novel, cost-effective therapeutic options to alleviate the economic impact of DLBCL.
- Sustainable financial strategies are required to support the growing population of DLBCL patients.
Introduction:
Diffuse large B-cell lymphoma (DLBCL) is the most common form of non-Hodgkin's lymphoma with increasing prevalence. Although the disease burden associated with DLBCL is high, only limited data on healthcare resource utilization (HCRU) and associated costs of German patients with DLBCL is available.
Methods:
Using a large claims database of the German statutory health insurance with 6.7 million enrollees, we identified patients who were newly diagnosed with DLBCL between 2011 and 2018 (index date). Treatment lines were identified based on a predefined set of medication. HCRU and related costs were collected for the entire post index period and per treatment line.
Results:
A total of 2495 incident DLBCL patients were eligible for the analysis. The average follow-up time after index was 41.7 months. During follow-up, 1991 patients started a first-line treatment, 868 a second-line treatment, and 354 a third-line treatment. Overall, patients spent on average (SD) 5.24 (6.17) days per month in hospital after index. While on anti-cancer treatment, this number increased to nine (10.9) in first-line, 8.7 (13.7) in second-line, and 9.4 (15.8) in third-line treatments. Overall costs per patient per month (PPPM) increased from €421 (875.70) before to €3695 (4652) after index. While on a treatment line, PPPM costs were €17,170 (10,246) in first-line, €13,362 (12,685) in second-line, and €12,112 (16,173) in third-line treatments. Time-unadjusted absolute costs sum up to €59,868 (43,331), €35,870 (37,387), and €28,832 (40,540) during first-line, second-line, and third-line treatments, respectively. The main cost drivers were hospitalizations (71% of total costs) and drug acquisition costs (18% of total costs).
Conclusions:
The financial burden of DLBCL in Germany is high, mainly due to hospitalization and drug costs. Therefore, there is a high medical need for new cost-effective therapeutic options that can lower the disease burden and remain financially viable to support the growing number of patients with this aggressive disease.
