Peripheral T-Cell Lymphoma Represents High Clinical Burden, Resource Utilization, and Costs

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Peripheral T-cell lymphoma (PTCL) is associated with high resource utilization rates and high overall costs, according to a multicenter study. Hospitalizations, in particular, represent a major clinical and economic burden, leading to a need for the development of treatments requiring lower resource utilization with better PTCL management.

Michele H. Potashman, PhD, of the Takeda Oncology Company, Cambridge, MA, and colleagues studied 1000 patients with PTCL identified by ICD-9 diagnosis codes over the period from October 1, 2007, through June 30, 2011. Truven MarketScan data for commercially insured and Medicare supplemental patients were used to retrospectively identify unique PTCL patients. This database comprises medical and pharmaceutical claims for >100 million unique patients across the United States.

All patients were required to have at least 6 months of continuous enrollment before and 12 months of continuous enrollment after their index date.
Mean patient age was 56 years, 58% were male, and all patients had a higher frequency of comorbidities (mean Charlson Comorbidity Index of 1.72 vs 0.39 for the control group).

The control group (n=5000) included randomly selected non-PTCL patients and was considered to represent the average insured patient population from the US payer perspective, according to the authors.

The study calculated healthcare costs per month, measured and annualized to provide average yearly costs. Healthcare costs included hospitalizations, pharmacy services, office visits, emergency room visits, hospice stays, stem cell transplant, and other patient-related costs such as laboratory procedures, blood transfusions, and radiology procedures.

Higher Annual Costs
“On an average annual basis, PTCL patients were hospitalized more often and experienced a longer length of stay compared with matched controls,” noted Potashman. “In addition, PTCL patients had higher utilization of office visits, pharmacy services, emergency room visits, and hospice care.”

Overall, PTCL patients incurred much higher average annual costs compared with matched controls ($75,934.08 vs $4,660.64), driven mainly by hospitalizations (32.2% of overall costs) and pharmacy services (19.6% of overall costs). Fifty percent of PTCL patients compared with 13.8% of controls had hospitalizations. Emergency room visits were almost twice as frequent in the PTCL patients (47.0% vs 25.0%).

The mean cost of hospitalization per patient was $24,417 in the PTCL patients versus $1058 for controls (P<.0001).

Some 11.4% of PTCL patients had stem cell transplant compared with none of the controls. Mean cost per transplant patient in the PTCL cohort for a first stem cell transplant was $126,093.58.

The most common diagnosis codes associated with hospitalization were fever, fatigue, dizziness, dyspnea, chest pain, cough, and other chest symptoms.

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