TITLE:
Differences in Treatment Patterns and Health Care Costs among Non-Hodgkin’s Lymphoma and Chronic Lymphocytic Leukemia Patients Receiving Rituximab in the Hospital Outpatient Setting versus the Office/Clinic Setting
AUTHORS:
Stacey DaCosta Byfield, Art Small, Laura K. Becker, Carolina M. Reyes
KEYWORDS:
Lymphoma; Leukemia; Rituximab; Treatment Setting; Costs
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.5 No.2,
February
26,
2014
ABSTRACT:
Objective: To examine whether differences in treatment patterns and
health care costs exist among chronic lymphocytic leukemia (CLL) and
non-Hodgkin’s lymphoma (NHL) patients receiving rituximab in a hospital
outpatient setting versus those receiving rituximab in a
physician office/community clinic setting. Methods: This retrospective database
study used medical and pharmacy claims (1/2007-7/2012) from a large US health
plan. Patients ≥18 years with ≥2 rituximab claims and ≥2 claims for either NHL
or CLL were identified. The date of the first rituximab claim were set as the index date, and differences in treatment patterns and health
care costs were examined during the period following the index date. Costs were
adjusted for patient characteristics using a multivariate regression model.
Results: A total of 4441 patients were identified; 3167 received rituximab in the
office/clinic setting, and 1274 in the hospital outpatient setting. From 2007
to 2012, the percentage of patients receiving rituximab in the hospital
outpatient setting increased from 22% to 39%. Patients treated in the hospital
outpatient setting vs. the office/clinic setting had fewer average counts of
rituximab infusions (5.60 vs. 7.49, p 0.001), higher total health care costs (cost ratio = 1.325, p 0.001), higher
infusion day drug and administration costs (cost ratio = 1.509, p 0.001), and higher rates
of ER visits and inpatient stays (both p 0.001). Conclusions:
These findings suggest that site of care may impact treatment patterns and
costs of patients receiving rituximab, and additional research is needed to
better understand the reason(s) for these differences by site of service.