PMID- 31144473
OWN - NLM
STAT- MEDLINE
DCOM- 20200803
LR  - 20210109
IS  - 2045-7634 (Electronic)
IS  - 2045-7634 (Linking)
VI  - 8
IP  - 8
DP  - 2019 Jul
TI  - Treatment patterns, adverse events, and economic burden in a privately insured 
      population of patients with chronic lymphocytic leukemia in the United States.
PG  - 3803-3810
LID - 10.1002/cam4.2268 [doi]
AB  - INTRODUCTION: Contemporary data describing treatment patterns, adverse events 
      (AEs), and outcomes in patients with chronic lymphocytic leukemia (CLL) in 
      clinical practice are lacking. We conducted a retrospective cohort study and 
      assessed treatment patterns, AEs, health-care resource use (HCRU), and costs in 
      patients with diagnosis of CLL. METHODS: Using a nationally representative 
      population of privately insured patients in the US, adult patients with CLL 
      diagnosis (July 2012-June 2015) were selected if they had continuous health plan 
      enrollment for >/=12 months before the first CLL diagnosis without any evidence of 
      any CLL-directed treatment. Treatment patterns up to four lines of therapy (LOT) 
      and occurrence of AEs during CLL therapies were assessed. Mean per-patient 
      monthly HCRU and costs were assessed overall and by number of unique AEs. 
      RESULTS: Of all patients meeting the selection criteria (n = 7,639; median age, 
      66 years), 18% (n = 1,379) received a systemic therapy during study follow-up. Of 
      these, bendamustine/rituximab (BR) was the most common first observed regimen 
      (28.1%), while ibrutinib was the most common therapy in the second (20.8%) and 
      third (25.5%) observed regimens. The mean monthly all-cause and CLL-related 
      costs, among patients treated with a systemic therapy, were $7,943 (SD = $15,757) 
      and $5,185 (SD = $9,935), respectively. Mean monthly all-cause costs increased by 
      the number of AEs (from $905 [SD = $1,865] among those with no AEs to $6,032 
      [SD = $13,290] among those with >/=6 AEs). CONCLUSIONS: Chemoimmunotherapy, 
      particularly BR, was the most common first observed therapy for CLL, whereas 
      ibrutinib was most preferred in the second and third observed lines of therapy 
      during the study period. Findings demonstrate that the economic burden of AEs in 
      CLL is substantial.
CI  - (c) 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
FAU - Kabadi, Shaum M
AU  - Kabadi SM
AUID- ORCID: 0000-0002-9945-6491
AD  - AstraZeneca, Gaithersburg, Maryland.
FAU - Goyal, Ravi K
AU  - Goyal RK
AUID- ORCID: 0000-0003-1632-036X
AD  - RTI Health Solutions, Research Triangle Park, North Carolina.
FAU - Nagar, Saurabh P
AU  - Nagar SP
AD  - RTI Health Solutions, Research Triangle Park, North Carolina.
FAU - Kaye, James A
AU  - Kaye JA
AD  - RTI Health Solutions, Waltham, Massachusetts.
FAU - Davis, Keith L
AU  - Davis KL
AD  - RTI Health Solutions, Research Triangle Park, North Carolina.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20190529
PL  - United States
TA  - Cancer Med
JT  - Cancer medicine
JID - 101595310
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Antineoplastic Combined Chemotherapy Protocols/adverse effects/therapeutic use
MH  - *Cost of Illness
MH  - Disease Management
MH  - Female
MH  - Health Care Costs
MH  - Humans
MH  - *Insurance Coverage
MH  - Insurance, Health
MH  - Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis/*epidemiology/mortality/therapy
MH  - Male
MH  - Middle Aged
MH  - Patient Selection
MH  - *Practice Patterns, Physicians'
MH  - United States/epidemiology
MH  - Young Adult
PMC - PMC6639180
OTO - NOTNLM
OT  - adverse events
OT  - chronic lymphocytic leukemia (CLL)
OT  - economic burden
OT  - treatment patterns
COIS- Shaum M. Kabadi is a full-time employee of AstraZeneca, the funding organization. 
      Ravi K. Goyal, Saurabh P. Nagar, Keith L. Davis, and James A. Kaye are full-time 
      employees of RTI Health Solutions, which received funding from AstraZeneca to 
      conduct this research.
EDAT- 2019/05/31 06:00
MHDA- 2020/08/04 06:00
PMCR- 2019/05/29
CRDT- 2019/05/31 06:00
PHST- 2019/03/21 00:00 [received]
PHST- 2019/05/08 00:00 [revised]
PHST- 2019/05/09 00:00 [accepted]
PHST- 2019/05/31 06:00 [pubmed]
PHST- 2020/08/04 06:00 [medline]
PHST- 2019/05/31 06:00 [entrez]
PHST- 2019/05/29 00:00 [pmc-release]
AID - CAM42268 [pii]
AID - 10.1002/cam4.2268 [doi]
PST - ppublish
SO  - Cancer Med. 2019 Jul;8(8):3803-3810. doi: 10.1002/cam4.2268. Epub 2019 May 29.