Studies Highlight the Cost Burden of Diffuse Large B-Cell Lymphoma

The cost to treat relapse/refractory diffuse large B-cell lymphoma (RR DLBCL) can be high—and that’s only taking into account first- and second-line treatments that can cost as much as $200,000. A study abstract¹ presented at the International Society of Pharmacoeconomics and Outcomes Research Annual International Meeting estimated the lifetime direct medical costs of third-line and subsequent treatment costs for this disease.

The authors used the Average Sales Price of therapies, plus the direct costs to providers in 2017 to determine the cost of third-line therapies. Other costs considered included adverse events, treatment administration and monitoring, disease management, and future healthcare costs.

They found that lifetime costs can range from $600,000 to $750,000, with the costs of adverse events related to third-line treatment representing 30% of the total cost. Other leading cost drivers include treatment acquisition (28%) and subsequent therapy (21%).

After including the costs of first- and second-line therapies, the lifetime cost of treating RR DLBCL can approach and surpass $1 million. More research on real-world lifetime costs and outcomes can help to inform future treatment decision models, the authors note.

“More effective novel therapies can moderate lifetime costs by ensuring durable remission, which may offset the proportion of patients who proceed to subsequent treatment,” the authors concluded. “Economic evaluations of novel therapies should consider long-term outcomes as they are major contributors to lifetime costs.”

Another study² analyzed how being newly diagnosed with DLBCL can increase the cost burden of chronic conditions in elderly Medicare beneficiaries. The authors examined costs for 5455 patients with DLBCL who were older than 65 years and compared them with 14,7000 people without cancer during a 3-year period. They used the Surveillance, Epidemiology, and End Results-Medicare 2002-2013 data to estimate costs during prediagnosis and postdiagnosis.

The authors found that the difference in total cost between the 2 groups increased significantly, from $468.80 in the prediagnosis period to $60,746.10 at the beginning of the postdiagnosis period. While patients with DLBCL had higher costs for heart conditions, they had lower costs of hypertension, asthma/chronic obstructive pulmonary disease, mental illness, and diabetes compared with the group of patients without cancer. The authors noted that the cardiotoxicity of DLBCL treatments may explain the increase cost of heart conditions.

“DLBCL patients might be receiving less healthcare services for other conditions, leading to lower short-term costs of other, common chronic conditions,” the authors concluded. “Future studies are recommended to investigate the cost-effectiveness of increasing the quality of care for chronic conditions among DLBCL patients.”

References

1. Garcia J, Snyder S, Gitlin M. Estimating the lifetime costs in adult patients with relapsed/refractory diffuse large B-cell lymphoma in the United States. Presented at the International Society of Pharmacoeconomics and Outcomes Research Annual International Meeting. May 22, 2018; Baltimore, Maryland. Abstract PCN94.

2. Garg R, Sambamoorthi U, Tan X, Basu S, Haggerty T, Kelly K. Impact of diffuse large B-cell lymphoma on costs of chronic conditions in elderly Medicare beneficiaries. Presented at the International Society of Pharmacoeconomics and Outcomes Research Annual International Meeting. May 22, 2018; Baltimore, Maryland. Abstract PCN91.