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Lifetime Costs for Treated Follicular Lymphoma Patients in the US

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Abstract

Background and Objective

The objective of this study was to estimate the lifetime costs of patients receiving treatment for follicular lymphoma (FL) in the United States.

Methods

A Markov model was programmed in hēRo3 with a 6-month cycle length, 35-year time horizon (lifetime projection), and health states for line of treatment, response, receipt of maintenance therapy among responders, transformation to diffuse large B-cell lymphoma (DLBCL), development of second primary malignancy (SPM), and death. The model was used to estimate the expected lifetime costs of FL (in 2019 USD), including costs of drug acquisition and administration, transplant procedures, radiotherapy, adverse events, follow-up, DLBCL, SPM, end-of-life care, and indirect costs. Model inputs were based on published sources.

Results

In the US, patients with FL receiving treatment have a life expectancy of approximately 14.5 years from initiation of treatment and expected lifetime direct and indirect costs of US$515,884. Costs of drugs for induction therapy represent the largest expenditure (US$233,174), followed by maintenance therapy costs (US$88,971) and terminal care costs (US$57,065). Despite the relatively advanced age of these patients, indirect costs (due to patient morbidity and mortality and caregiver lost work time) represent a substantial share of total costs (US$40,280). Treated FL patients spend approximately 6.9 years in the health states associated with first-line therapy. Approximately 66 and 46% continue to second- and third-line therapies, respectively. The mean (95% credible interval) of expected lifetime costs based on the probabilistic sensitivity analyses was US$559,202 (421,997–762,553).

Conclusions

In the US, the expected lifetime costs of care for FL patients who receive treatment is high. The results highlight the potential economic benefits that might be achieved by treatments for FL that prevent or delay disease progression.

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Authors and Affiliations

  1. Policy Analysis Inc. (PAI), Chestnut Hill, MA, USA

    Caitlin Eichten, Thomas E. Delea & May Hagiwara

  2. Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA

    Qiufei Ma, Roberto Ramos, Şerban R. Iorga & Jie Zhang

  3. Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA

    Richard T. Maziarz

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Corresponding author

Correspondence to Thomas E. Delea.

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Funding

Support for this study was provided by Novartis, Inc., East Hanover, NJ, USA. The authors were responsible for all content and editorial decisions, and they received no honoraria related to the development of this publication.

Conflict of interests

TED is an employee and owner of PAI. PAI received research funding from Novartis for this study. CE and MH are employees of PAI. PAI received research funding from Novartis for this study. QM, RR, SRI, and JZ are employees of Novartis. Novartis provided research funding to PAI for this study. RTM: Honoraria, membership on an entity’s Board of Directors or advisory committees and research funding: Novartis; Consultancy and honoraria: Incyte, Juno; Honoraria: Kite, Jazz Pharmaceuticals; Patents & Royalties: Athersys, Inc.; Employment: Oregon Health & Science University (OHSU); with regard to the consultant services and payment from Novartis, this potential conflict of interest has been reviewed and managed by OHSU.

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Data availability statement

The authors declare that all input data to parameterize the model are available within the article. The model can be re-built entirely based on the information provided.

Code availability

The information reported in this article is sufficient to replicate the results of the study. The model used in the article includes a proprietary code and is not provided.

Author contributions

TED, CE, MH, QM: Study design, data collection, data analysis, interpretation of results, writing of draft and final manuscript. RR, JZ, SRI, RTM: Data collection, data analysis, interpretation of results, writing of draft and review of final manuscript.

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Eichten, C., Ma, Q., Delea, T.E. et al. Lifetime Costs for Treated Follicular Lymphoma Patients in the US. PharmacoEconomics 39, 1163–1183 (2021). https://doi.org/10.1007/s40273-021-01052-3

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