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Aim: Evaluate healthcare resource utilization (HRU) and costs in chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) who relapsed or are refractory to (R/R) ibrutinib.Methods: All-cause and CLL/SLL-related HRU and healthcare costs were evaluated in adult patients with CLL/SLL who received ibrutinib (2/2014-3/2020) as single-agent or combination therapy and discontinued/switched to another antineoplastic agent (R/R) vs. all other (non-R/R) ibrutinib users.Results: Compared with the non-R/R patients (N = 919), R/R patients (N = 207) had higher all-cause HRU (inpatient, outpatient and emergency room visits; rate ratios [95% CIs]: 1.51 [1.38, 1.65]-1.92 [1.57, 2.37]; all P < 0.001) and healthcare costs ($81,645 vs. $34,717; cost difference [95% CI] = $50,170 [$40,555, $61,383]; P < 0.001).Conclusion: CLL/SLL patients who are R/R to ibrutinib bear a substantial economic burden.
Ibrutinib is a drug often prescribed for chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL)two similar types of blood cancer-that returns/does not show improvement after a previous treatment (i.e., to patients who relapse after/are refractory to [R/R] the treatment). CLL/SLL that is R/R to ibrutinib can be costly because patients are left with fewer options for treatment and their cancer is likely to worsen. Knowing how much medical services are used and their cost when treating CLL/SLL that is R/R to ibrutinib can help patients, doctors and policy makers make informed decisions. In this study, the authors compared the use of healthcare resources-which included visits to the hospital, emergency room and doctor's officeand associated costs between patients with CLL/SLL in the United States who were R/R to ibrutinib and those who were not (non-R/R patients). The study showed that healthcare resource use and CLL/SLL-related medical costs were approximately two-times higher in R/R patients than in non-R/R patients. Thus, there is a substantial economic burden associated with R/R CLL/SLL.
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BACKGROUND AND AIMS: Exacerbations of chronic obstructive pulmonary disease (COPD) drive disease progression and can lead to an accelerated decline in lung function and a burden on healthcare systems. The retrospective, observational cohort Study on HEalthcare Resource utiLization related to exacerbatiOns in patients with COPD (SHERLOCK; D5980R00014) evaluated the associations between exacerbation history and rates of subsequent COPD exacerbations in primary care patients from the National Health Service in Greater Glasgow and Clyde, United Kingdom. METHODS: Patients were stratified into four groups according to exacerbation history in the year before the index date: Group A (no exacerbations), Group B (1 moderate exacerbation only), Group C (1 severe exacerbation only), and Group D (⩾2 moderate or severe exacerbations). The frequencies of moderate and/or severe exacerbations were recorded over 36 months of follow-up and compared with reference Group A, using generalized linear models. RESULTS: Over 36 months of follow-up, the adjusted rate ratios (RRs, 95% confidence interval) of moderate or severe exacerbations relative to Group A were 1.60 (1.53, 1.67), 1.75 (1.50, 2.04), 1.61 (1.54, 1.68), and 3.61 (3.48, 3.74) for Groups B, C, B + C, and D, respectively. Compared with Group A, patients in Group C exhibited an increased rate of moderate (RR, 1.58 (1.35, 1.85)) and severe exacerbations (RR, 3.13 (2.20, 4.46)). CONCLUSION: SHERLOCK highlights that even one moderate exacerbation increases the risk for subsequent exacerbations compared with having no recent prior exacerbations. Reviewing recent exacerbation history to ascertain future exacerbation risk and inform COPD management may reduce hospitalizations and improve patient outcomes.