Real-Word CLL Patient Data Shows Substantial Economic Burden for Medicare

Adverse events (AEs) experienced by patients with chronic lymphocytic leukemia (CLL) account for substantial economic burden, according to a study published in Cancer Medicine.

For the study, researchers examined real-world patient outcomes and costs associated with CLL from existing clinical trial data. In a population-based retrospective cohort study, researchers assessed overall survival (OS), incidence of AEs, and real-world economic burden for Medicare enrollees.

Patients from the Medicare claims database receiving one or more systemic therapies from 2013 to 2015 were included in the study through December 2016 or patient death.

Among 7965 patients, the most frequently recorded AEs were neutropenia, hypertension, anemia, and infection. Mean monthly all-cause cost during patient follow-up was $8974, with costs increasing per number of AEs from $5144 in patients with 1 to 2 AEs to $10,077 for those with 6 or more.

Most common treatments included ibrutinib monotherapy, chlorambucil monotherapy, and bendamustine/rituximab. Using the Kaplan-Meier method, 24-month OS estimates after first observed therapy were:

• 69% among 2708 ibrutinib monotherapy patients,

• 68% among 1620 chlorambucil monotherapy patients, and
• 79% among 1485 bendamustine/rituximab patients.

“Our findings highlight considerable susceptibility to AEs and unmet medical need in Medicare patients with CLL treated in routine practice,” researchers concluded. “Medicare incurred substantial economic burden following initiation of systemic therapy, and patients with greater numbers of AEs accounted disproportionately for the high overall cost of CLL management.”

—Maria Asimopoulos

Reference:
Goyal RK, Nagar SP, Kabadi SM, et al. Overall survival, adverse events, and economic burden in patients with chronic lymphocytic leukemia receiving systemic therapy: real-world evidence from the Medicare population. Cancer Med. 2021;10(8):2690-2702. doi:10.1002/cam4.3855