Merck & Co., Inc., Rahway, NJ, USA.
Analysis Group, Inc., Denver, CO, USA.
Oncologist. 2024 Mar 4;29(3):e360-e371. doi: 10.1093/oncolo/oyad324.
Chronic lymphocytic leukemia (CLL) is the most common type of leukemia among US adults and has experienced a rapidly evolving treatment landscape; yet current data on treatment patterns in clinical practice and economic burden are limited. This study aimed to provide an up-to-date description of real-world characteristics, treatments, and costs of patients with CLL or small lymphocytic lymphoma (SLL).
Using retrospective data from the Optum Clinformatics DataMart database (January 2013 to December 2021), adults with diagnosis codes for CLL/SLL on two different dates were selected. An adapted algorithm identified lines of therapy (LOT). Treatment patterns were stratified by the index year pre- and post-2018. Healthcare resource utilization and costs were evaluated per patient-years.
A total of 18 418 patients with CLL/SLL were identified, 5226 patients (28%) were treated with ≥1 LOT and 1728 (9%) with ≥2 LOT. Among patients diagnosed with CLL in 2014-2017 and ≥1 LOT (N = 2585), 42% used targeted therapy and 30% used chemoimmunotherapy in first line (1L). The corresponding proportions of patients diagnosed with CLL in 2018-2021 (N = 2641) were 54% and 16%, respectively. Total costs were numerically 3.5 times higher and 4.9 times higher compared with baseline costs among patients treated with 1L+ and 3L+, respectively.
This study documented the real-world change in CLL treatment landscape and the substantial economic burden of patients with CLL/SLL. Specifically, targeted therapies were increasingly used as 1L treatments and they were part of more than half of 1L regimens in recent years (2018-2021).
慢性淋巴细胞白血病(CLL)是美国成年人中最常见的白血病类型,其治疗领域迅速发展;然而,目前关于临床实践中的治疗模式和经济负担的数据有限。本研究旨在提供有关 CLL 或小淋巴细胞淋巴瘤(SLL)患者真实世界特征、治疗和成本的最新描述。
使用 Optum Clinformatics DataMart 数据库(2013 年 1 月至 2021 年 12 月)的回顾性数据,选择两次就诊均有 CLL/SLL 诊断代码的成年人。经过改编的算法确定了治疗线(LOT)。根据 2018 年前后的索引年对治疗模式进行分层。按患者-年评估医疗资源利用和成本。
共确定了 18418 例 CLL/SLL 患者,其中 5226 例(28%)接受了≥1 个 LOT 治疗,1728 例(9%)接受了≥2 个 LOT 治疗。在 2014-2017 年诊断为 CLL 且接受了≥1 个 LOT(N=2585)的患者中,42%在一线治疗中使用了靶向治疗,30%使用了化疗免疫治疗。在 2018-2021 年诊断为 CLL 的患者中(N=2641),这两个比例分别为 54%和 16%。接受 1L+和 3L+治疗的患者的总费用分别比基线费用高出近 3.5 倍和 4.9 倍。
本研究记录了 CLL 治疗领域的真实世界变化,以及 CLL/SLL 患者的巨大经济负担。具体来说,靶向治疗越来越多地作为一线治疗药物使用,近年来(2018-2021 年)已成为超过一半的 1L 治疗方案的一部分。