Bristol Myers Squibb, Princeton, New Jersey.
Bristol Myers Squibb, Princeton, New Jersey.
Transplant Cell Ther. 2022 Jul;28(7):404.e1-404.e6. doi: 10.1016/j.jtct.2022.03.021. Epub 2022 Mar 27.
The use of chimeric antigen receptor (CAR) T-cell therapy after a second relapse of diffuse large B-cell lymphoma (DLBCL) has shown favorable efficacy in clinical trials; however, little is known about health care resource utilization (HCRU) and costs of CAR T cell therapy for patients treated in real-world settings. We assessed treatment patterns, HCRU, costs, and safety in patients receiving CAR T cell therapy for relapsed or refractory DLBCL across 3 US commercial claims databases. Adults with DLBCL treated with CAR T cell therapy were identified in the following 3 claims databases: Optum® Clinformatics® Data Mart, IBM MarketScan® Commercial & Medicare Database, and IQVIA PharMetrics® Plus. Mean total costs were calculated and adjusted to 2019 US dollars. HCRU and costs within 3 months of infusion were stratified by safety events of interest, including neurological events (NEs) and cytokine release syndrome (CRS), identified via unvalidated algorithms designed based on expert medical opinion. A total of 191 patients receiving CAR T cell therapy were identified across the databases; their median age ranged from 56 to 67 years, and 63% to 75% were male. Most patients (88% to 98%) received CAR T cell infusions in the inpatient setting; 30% to 75% received bridging therapy. CRS was reported in 75% to 84% of patients (severe CRS, 15% to 32%), and NEs were reported in 58% to 69% (severe NEs, 25% to 43%). Mean total inpatient hospital days ranged from 17 to 22 days and increased with severe CRS (19 to 27 days) or severe NEs (22 to 29 days). Mean total health care expenditures ranged from $380,000 to $526,000 and were generally higher with severe CRS or NEs (∼$406,000 to $679,000). HCRU and costs associated with CAR T cell therapy may vary in the real world depending on several factors, including occurrence and severity of adverse events.
嵌合抗原受体 (CAR) T 细胞疗法在弥漫性大 B 细胞淋巴瘤 (DLBCL) 第二次复发后的应用已在临床试验中显示出良好的疗效;然而,对于真实世界环境中接受 CAR T 细胞治疗的患者,其医疗资源利用 (HCRU) 和成本的相关信息知之甚少。我们在 3 个美国商业索赔数据库中评估了接受 CAR T 细胞治疗的复发性或难治性 DLBCL 患者的治疗模式、HCRU、成本和安全性。在以下 3 个索赔数据库中鉴定出接受 CAR T 细胞治疗的 DLBCL 成年患者:Optum®Clinformatics®Data Mart、IBM MarketScan®Commercial & Medicare Database 和 IQVIA PharMetrics®Plus。计算了平均总成本,并调整为 2019 年的美元。根据基于专家医学意见设计的未经验证的算法,通过未经验证的算法确定了与安全性事件(包括神经事件 [NE] 和细胞因子释放综合征 [CRS])相关的输注后 3 个月内的 HCRU 和成本。在数据库中鉴定出了 191 名接受 CAR T 细胞治疗的患者;他们的中位年龄范围为 56 至 67 岁,63%至 75%为男性。大多数患者(88%至 98%)在住院环境中接受 CAR T 细胞输注;30%至 75%接受桥接治疗。75%至 84%的患者报告了 CRS(严重 CRS,15%至 32%),58%至 69%的患者报告了 NE(严重 NE,25%至 43%)。平均总住院天数范围为 17 至 22 天,并随着严重 CRS(19 至 27 天)或严重 NE(22 至 29 天)而增加。平均总医疗保健支出范围为 380,000 美元至 526,000 美元,并且随着严重 CRS 或 NE 的发生而普遍更高(约 406,000 美元至 679,000 美元)。根据发生和严重程度等多种因素,CAR T 细胞治疗相关的 HCRU 和成本在真实世界中可能会有所不同。
Cochrane Database Syst Rev. 2021-9-13
Curr Treat Options Oncol. 2025-4-28
Blood Cell Ther. 2024-11-1
JNCI Cancer Spectr. 2024-7-1
Hum Vaccin Immunother. 2023-12-31