Huntington Scott, Keshishian Allison, McGuire Michael, Xie Lin, Baser Onur
a Department of Medicine , Section of Hematology, Yale University School of Medicine , New Haven , CT , USA.
b STATinMED Research , Ann Arbor , MI , USA.
Leuk Lymphoma. 2018 Dec;59(12):2880-2887. doi: 10.1080/10428194.2018.1459613. Epub 2018 Jun 25.
While health care costs can be considerable in individuals with diffuse large B-cell lymphoma (DLBCL), the degree to which health care expenditures vary following first-line treatment for non-relapsed versus relapsed DLBCL is unknown. Using 100% Medicare claims, we identified beneficiaries with DLBCL treated with first-line therapy between 1 January 2010 and 30 June 2014. We then compared health care expenditures of patients who received a second-line immunochemotherapy (relapse cohort) to those who did not begin a second-line therapy during follow-up (non-relapse cohort). After propensity score matching, the relapsed cohort incurred significantly higher health care costs ($6998 vs $3314 per month; p < .001), driven by inpatient ($2548 vs $1943 per month; p < .001) and outpatient office visit costs ($3581 vs $753 per month; p < .001). Our analysis confirms older adults with relapsed DLBCL incur higher medical costs and suggests improved first-line treatment would not only reduce the likelihood of relapse, but also contain health care costs.
虽然弥漫性大B细胞淋巴瘤（DLBCL）患者的医疗费用可能相当可观，但初次治疗后，非复发性与复发性DLBCL患者的医疗支出差异程度尚不清楚。我们利用100%的医疗保险理赔数据，确定了2010年1月1日至2014年6月30日期间接受一线治疗的DLBCL受益患者。然后，我们将接受二线免疫化疗的患者（复发队列）与随访期间未开始二线治疗的患者（非复发队列）的医疗支出进行了比较。倾向得分匹配后，复发队列的医疗费用显著更高（每月6998美元对3314美元；p < 0.001），住院费用（每月2548美元对1943美元；p < 0.001）和门诊就诊费用（每月3581美元对753美元；p < 0.001）是导致这种情况的原因。我们的分析证实，复发的老年DLBCL患者医疗费用更高，并表明改进一线治疗不仅会降低复发的可能性，还会控制医疗费用。
