Analysis Group, Inc., Boston, MA, USA.
Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA.
Leuk Lymphoma. 2023 Feb;64(2):339-348. doi: 10.1080/10428194.2022.2147395. Epub 2022 Nov 21.
Chimeric antigen receptor T-cell (CAR-T) infusion settings may impact healthcare resource use (HRU) and reimbursement amounts. Adults with diffuse large B-cell lymphoma receiving CAR-T therapy were identified from the Centers for Medicare & Medicaid Services (CMS) 100% fee-for-service Medicare database and stratified into inpatient (IP; = 380) and outpatient (OP; = 50) cohorts based on CAR-T infusion setting. During the first month post-infusion, OP cohort had significantly fewer IP visits, IP days, intensive care unit (ICU) stays, ICU days, and significantly more OP, emergency room (ER) visits, than IP cohort. In subsequent months, HRU became comparable between cohorts. Medicare reimbursement amounts during the first month post-infusion were nominally higher in the OP vs. IP cohort and comparable in subsequent months. The reimbursement amounts did not reflect the reduced HRU with OP infusions, potentially due to differences in Medicare payment policies for OP vs. IP services.
嵌合抗原受体 T 细胞（CAR-T）输注方案可能会影响医疗资源的使用（HRU）和报销金额。从美国医疗保险和医疗补助服务中心（CMS）100%按服务收费的医疗保险数据库中确定了接受 CAR-T 治疗的弥漫性大 B 细胞淋巴瘤成人患者，并根据 CAR-T 输注方案将其分为住院（IP； = 380）和门诊（OP； = 50）队列。在输注后第一个月，OP 队列的住院访问次数、住院天数、重症监护病房（ICU）入住天数、ICU 天数明显少于 IP 队列，而 OP 队列的门诊访问次数、急诊室（ER）访问次数明显多于 IP 队列。在随后的几个月中，两个队列的 HRU 变得相当。输注后第一个月的 Medicare 报销金额在 OP 队列中略高于 IP 队列，而在随后的几个月中则相当。报销金额并没有反映出 OP 输注带来的 HRU 减少，这可能是由于 OP 与 IP 服务的 Medicare 支付政策存在差异。
