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Patient characteristics, healthcare resource utilization and costs across treatment lines in diffuse large B-cell
Katja Greth1, Moritz Lehne1, Marco Ghiani1
1Cytel Inc., Berlin, Germany.
Insights
This study of German diffuse large B-cell lymphoma (DLBCL) patients highlights significant clinical complications and healthcare costs across treatment lines. Findings underscore the urgent need for improved DLBCL therapies.
Area of Science:
- Hematology
- Oncology
- Health Services Research
Background:
- Limited real-world data exists for diffuse large B-cell lymphoma (DLBCL) in Germany.
- Understanding DLBCL patient characteristics, treatment patterns, and outcomes is crucial for improving care.
- German claims data offers a valuable resource for analyzing DLBCL across different treatment lines.
Purpose of the Study:
- To assess baseline characteristics, treatments, clinical complications, healthcare resource utilization, and costs for DLBCL patients in Germany.
- To analyze these factors across first (1L), second (2L), and third line (3L) treatment settings.
- To identify unmet needs and inform the development of novel DLBCL treatment strategies.
Main Methods:
- Retrospective cohort study utilizing German claims data (AOK PLUS) from 2012-2022.
- Identification of incident diffuse large B-cell lymphoma (DLBCL) cases.
- Stratification of patients into 1L, 2L, and 3L treatment groups based on German treatment guidelines; descriptive analysis of outcomes.
Main Results:
- 2423 DLBCL patients received 1L treatment; 49.7% and 20.8% progressed to 2L and 3L, respectively.
- High rates of clinical complications observed, particularly in 3L, including neutropenia, pneumonia, anemia, thrombocytopenia, and sepsis.
- Significant healthcare resource utilization and costs associated with DLBCL treatment, with higher costs in 3L compared to 2L.
Conclusions:
- The high proportion of patients requiring second or later-line treatment indicates a significant burden of relapsed or refractory DLBCL.
- Low utilization of stem cell transplant (SCT) and chimeric antigen receptor T-cell therapy (CAR-T) noted.
- The substantial clinical complications and healthcare resource use highlight the critical need for more effective and tolerable DLBCL treatments.
Abstract:
Aim: Given the limited availability of real world diffuse large B-cell lymphoma (DLBCL) data in Germany, we assessed the baseline characteristics, treatments, clinical complications, healthcare resource utilization and costs of DLBCL across treatment lines using German claims data. Materials & methods: In a retrospective cohort study using claims data from a German sickness fund (AOK PLUS), we identified patients with an incident DLBCL diagnosis between 2012 and 2022. Using an algorithm based on German treatment guidelines, patients were stratified into first (1L), second (2L) and third line (3L) treatment. We then descriptively analyzed baseline characteristics, treatments, clinical complications, healthcare resource utilization and costs. Results: A total of 2423 patients with DLBCL and 1L treatment were included in the study (49.1% female; mean age: 69.7 years; mean CCI: 7.0; median follow-up: 29.3 months). A total of 1209 (49.7%) and 505 (20.8%) patients progressed to 2L and 3L, respectively. A total of 209 patients received a stem cell transplant (SCT; mean age: 56.1 years); 37 received a chimeric antigen receptor T-cell therapy (CAR-T; mean age: 60.8 years). Most patients had at least one DLBCL related hospitalization during follow-up (1L: 79.2%; 2L: 60.0%; 3L: 71.9%; mean length of stay [days/patient year]: 1L: 15.2; 2L: 6.4; 3L: 14.2), with corresponding hospitalization costs of 12,777€ (1L), 5993€ (2L) and 17,408€ (3L) per patient year. Clinical complications were common, particularly in 3L, including neutropenia (1L: 31.9%; 2L: 27.0%; 3L: 46.9%), pneumonia (1L: 19.6%; 2L: 16.8%; 3L: 30.3%), anemia (1L: 17.8%; 2L: 18.7%; 3L: 35.2%), thrombocytopenia (1L: 17.3%; 2L: 21.8%; 3L: 45.1%) and sepsis (1L: 14.6%; 2L: 13.0%; 3L: 23.2%). Conclusion: The high proportion of patients with second or later-line treatment (indicating a relapse or refractory disease), the low number of SCTs together with many clinical complications and healthcare resource use underscore the need for novel effective and well-tolerated DLBCL treatment options.
