February 2014 Vol 7, No 1, Special Issue ASH 2013 Payers' Perspectives in Oncology - Health Economics
Wayne Kuznar

Aretrospective analysis of rituximab infusions presented at the meeting showed that more patients with diffuse large B-cell lymphoma (DLBCL) receive the infusions in the hospital setting, incurring greater costs than those receiving them in the office/clinic.

Rituximab in combination with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) is the recommended first-line therapy for DLBCL.

Carolina Reyes, PhD, of Genentech, San Francisco, CA, examined differences in treatment patterns, healthcare resource use, and costs among patients with DLBCL receiving rituximab plus chemotherapy in the office setting versus the hospital outpatient setting.

Medical and pharmacy claims from a large, geographically diverse US commercial health plan were used to identify 491 adults with DLBCL with 2 or more claims for rituximab, 65% of whom received infusions in the office or clinic, and 35% of whom received them in the hospital.

The percentage of patients receiving infusions in the hospital increased from 32% in 2007 to 43% in 2011/2012.

The mean length of episode of care was not significantly different by the site of service, and the mean number of rituximab infusions was lower (4.92) in the hospital versus the office (6.52), as was the mean number of infusions per month (1.01 vs 1.17, respectively).

The total mean costs during the episode of care, as well as administration costs incurred on days of rituximab infusions, were significantly higher among the hospital cohort compared with the office/clinic cohort.

The unadjusted mean infusion-day costs were $12,481 in the hospital cohort versus $5834 in the office/clinic cohort.

“Higher infusion-day costs contributed to higher unadjusted mean per patient per month [PPPM] costs among the hospital cohort,” noted Dr Reyes. Total unadjusted PPPM costs in the hospital cohort were $22,325 compared with $15,541 for the office/clinic cohort.

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