Economic burden of treatment failure in chronic lymphocytic leukemia patients

• Published in: Current medical research and opinion 2018-06, Vol.34 (6), p.1135-1142
• Main Authors: Wang, Song, Lafeuille, Marie-Hélène, Lefebvre, Patrick, Romdhani, Hela, Emond, Bruno, Senbetta, Mekré
• Format: Article
• Language: English
• Subjects: Chronic lymphocytic leukemia; healthcare costs; treatment failure
• ISSN: 0300-7995; 1473-4877
• DOI: 10.1080/03007995.2018.1464904

Objective: This study assessed healthcare costs of first-line treatment failure (TF) in patients with chronic lymphocytic leukemia (CLL), a subtype of non-Hodgkin's lymphoma. Methods: Pre-diagnosis treatment-naïve adults with ≥2 CLL diagnoses initiated on an antineoplastic agent (index date) after their first CLL diagnosis with ≥12 and ≥6 months of continuous observation pre- and post-index, respectively, were selected from the Truven Health MarketScan Research Databases. Patients had no solid malignancies in the pre-index period nor selected blood malignancies at any time. Initial therapy included antineoplastic agents initiated in the first 30 days post-index. TF occurred at the earliest of: initiation of a new antineoplastic agent, treatment resumption following a ≥3 month break, non-chemotherapy intervention (stem cell transplant or radiotherapy), hospice care or hospital mortality. The cost of TF was evaluated as the healthcare cost difference between patients with and without first-line TF using ordinary least square regressions adjusted for baseline characteristics. Non-parametric bootstrap was used to evaluate statistical significance. Results: Among 2226 patients identified (mean age: 68 years; female: 41%), 46% experienced first-line TF. The average TF cost was $3011 per patient per month (p