Treatment patterns and costs of care for patients with relapsed and refractory Hodgkin lymphoma treated with brentuximab vedotin in the United States: A retrospective cohort study

PLoS One. 2017 Oct 9;12(10):e0180261. doi: 10.1371/journal.pone.0180261. eCollection 2017.

Abstract

Objectives: Although brentuximab vedotin (BV) has changed the management of patients with relapsed or refractory Hodgkin lymphoma (RRHL), little information is available on routine clinical practice. We identified treatment patterns and costs of care among RRHL patients in the United States (US) treated with BV.

Methods: A retrospective observational study of adults initiating BV for RRHL from 2011-2015, with ≥6 months of data prior to and following BV initiation, was conducted. Treatments were classified based on dispensations and chemotherapy administration. Median total and monthly costs were estimated based on all-cause healthcare resource use in 2015 US dollars (USD).

Results: The cohort comprised 289 patients (59% male; mean age at diagnosis, 42 years) with a mean follow-up of 250 weeks. Eleven percent had BV salvage therapy prior to ASCT, and 32% had BV for a relapse post-ASCT. 43% received treatment post-BV, most commonly allogeneic stem cell transplant (SCT) and bendamustine (both 10.2%). Median (IQR) total costs from BV initiation to censoring were 294,790 (142,110-483,360) USD; and were highest among those treated with BV prior to ASCT (up to 421,900 [300,940-778,970] USD). Median monthly costs were almost 20,000 USD per month, and up to 25,000 USD per month among those with BV and ASCT. Medications were the greatest driver of median monthly costs.

Conclusions: Median total all-cause costs were almost 300,000 USD, and median monthly costs approximately 20,000 USD, per patient treated. Patients requiring treatment following BV continue to incur high costs, highlighting the economic burden associated with managing patients in the RRHL setting.

MeSH terms

  • Adult
  • Brentuximab Vedotin
  • Female
  • Health Care Costs
  • Hodgkin Disease / drug therapy*
  • Hodgkin Disease / economics*
  • Hodgkin Disease / epidemiology
  • Humans
  • Immunoconjugates / economics*
  • Immunoconjugates / therapeutic use*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / drug therapy*
  • Neoplasm Recurrence, Local / economics*
  • Neoplasm Recurrence, Local / epidemiology
  • Retrospective Studies
  • Treatment Outcome
  • United States / epidemiology

Substances

  • Immunoconjugates
  • Brentuximab Vedotin

Grants and funding

This research was sponsored by Bristol-Myers Squibb; and two co-authors (IH and AJG) were employees of BMS at the time of the conduct of the study; AJG is presently an employee of BMS. While both IH and AJG participated in the study design, interpretation of the findings, and development of the manuscript, the publication of the research was not contingent on the sponsor’s approval or censorship of the manuscript.