In a recent study, a Yale Cancer Center team confirmed expectations of higher healthcare utilization and costs with relapsed Diffuse Large B-Cell Lymphoma (DLBCL). Using 100% Medicare claims data, the team measured health care utilization following completion of first-line therapy for DLBCL. The findings were presented December 4 at the American Society of Hematology (ASH) meeting in San Diego.
The team reviewed Medicare claims data to identify older adults (≥65 years) diagnosed with DLBCL between January 1, 2010 -- June 30, 2014. All patients were required to have continuous medical enrollment for 12 months before treatment began and to have received at least one full cycle of valid DLBCL regimen. The team identified 5,909 Medicare beneficiaries who completed first-line treatment for DLBCL, of which 1,552 had claims indicating second-line therapy during follow up (relapsed group).
In the period following first-line therapy, patients who relapsed had higher healthcare utilization, including hospital admissions (60.7% vs. 41.1%), emergency room visits (51.7% vs. 43.0&), use of skilled nursing facilities (19.3% vs. 12.5%), home health agency (35.5% vs. 23.3%), and hospice services (19.9% vs. 6.3%) compared to non-relapse patients. Consequently, higher total all-cause health care costs per patient per month were observed in the relapse group ($6,566 vs. $1,951).
"Significant numbers of Medicare beneficiaries treated for DLBCL experience progressive disease and receive therapy beyond the first-line setting. It's evident that improvements in first-line DLBCL therapy in older adults may offer significant health care savings in addition to improved clinical outcomes for these patients," said Scott Huntington, MD, MPH, Assistant Professor of Medicine at Yale Cancer Center and senior author on the study.
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