Relapsed, Refractory Hodgkin Lymphoma Has High Economic Burden of Care

There is a high economic burden associated with the treatment of relapsed or refractory Hodgkin lymphoma. A recent study published in PLoS One found that patients undergoing treatment for the disease incurred a median total all-cause cost of about $300,000.

“These findings augment the scarce real-world data on outcomes among patients with relapsed or refractory Hodgkin lymphoma, and can be used as benchmarks against which to compare treatment patterns, costs, and outcomes after the introduction of emerging therapies,” wrote Shelagh M. Szabo, of Broadstreet Health Economics & Outcomes Research in Vancouver, and colleagues. With this study, Szabo and colleagues wanted to quantify the real-world costs of management of patients with relapsed or refractory Hodgkin lymphoma.

Brentuximab vedotin (BV) is used in the treatment of patients with Hodgkin lymphoma who relapse after autologous stem cell transplant, or in those who are not candidates for transplant and have failed two or more prior chemotherapy regimens.

The researchers looked at data from 289 adult patients who initiated BV for relapsed or refractory Hodgkin lymphoma between 2011 and 2015. Median costs were estimated based on all-cause healthcare resource use in 2015 US dollars.

Mean follow-up of patients was 250 weeks. About 1 in 10 patients had BV salvage therapy prior to undergoing transplant, and 32% had BV for relapse after transplant. Forty percent of patients had BV within their second line of therapy, and 34.3% within their third line. Forty-three percent of patients received treatment post-BV; this occurred most commonly after allogeneic stem cell transplant and bendamustine.

The median total cost from the initiation of BV treatment to censoring was $294,790. These costs were highest among those patients treated with BV prior to transplant (up to $421,900). This translated to a median monthly cost of about $20,000 and as much as $25,000 per month among those who had BV and transplant.

According to the researchers, medications were the greatest driver of median monthly costs. Median medication costs were more than three times higher than median inpatient or outpatient costs in patients treated with BV who relapsed post-transplant, those without observed transplant, and for one patient on BV maintenance therapy after transplant.

“This retrospective study highlights the high clinical, and associated economic, burden of managing patients in the relapsed or refractory Hodgkin lymphoma setting with currently available therapies,” the researchers wrote.