Neurologic Adverse Events From DLBCL Treatment Boost Health Care

Neurologic toxicities from treatment for relapsed or refractory diffuse large B-cell lymphoma (DLBCL) increased total health care costs more than $70,000 on average for US patients, according to a study published recently in American Health & Drug Benefits. 

“This is the first study of the economic burden of neurologic adverse events associated with the treatment of relapsed or refractory DLBCL in a real-world setting, using data that reflect the current range of treatment options,” researchers wrote. “Patients with relapsed or refractory DLBCL who have severe or life-threatening neurologic adverse events incur substantially higher costs than patients without neurologic adverse events, with the largest difference seen in patients who receive chimeric antigen receptor (CAR) T-cell therapy.” 

Researchers used three nationally representative claims databases to identify adults with relapsed or refractory DLBCL who received CAR T-cell therapy, high-intensity cytotoxic therapy, low-intensity cytotoxic therapy, or targeted therapies. The retrospective study analyzed rates of neurologic adverse events and total health care costs for patients who did, and did not, experience neurologic adverse events within 30 days of treatment. 

Among a total 11,098 patients who received treatment, 2.7% experienced at least one neurologic adverse event, according to the study. Among the 118 patients who received CAR T-cell therapy, 36.4% experienced at least one neurologic adverse event. 

For patients with neurologic adverse events, the average total health care cost was $71,982 higher than for patients without neurologic adverse events, researchers found. For patients who received CAR T-cell therapy, the average total health care cost was $143,309 higher with neurologic adverse events than without such toxicities.  

“Patients who received CAR T-cell therapy had the greatest cost differences between patients with and without any neurologic adverse events,” researchers observed, “which may be driven by the major cost differences observed in patients with encephalopathy, the most common neurologic adverse events in patients who receive CAR T-cell therapy.”