Patients With Non-Hodgkin’s Lymphoma Subtypes Incur High Hospital Costs
According to published data, patients with mantle cell lymphoma (MCL), Waldenström macroglobulinemia (WM), marginal zone lymphoma (MZL), and chronic lymphocytic leukemia (CLL) experience frequent relapses over the course of several years, predisposing them to recurring hospitalizations and a significant related economic impact. A study team sought to examine real-world treatment patterns, costs, and healthcare resource utilization among patients with these lymphomas, as well as to pinpoint disparities and risk factors associated with costs incurred in US hospitals. The investigators performed a retrospective study using a geographically diverse, all-payer hospital administrative database with more than 1 billion inpatient and hospital-based outpatient encounters, including adult patients with MCL (N=3,387), WM (N=1,811), CLL (N=23,952), or MZL (N=2,655) who had at least one inpatient or two hospital-based outpatient visits from January 2014 through October 2019. They reviewed patient sociodemographic and hospital characteristics, all-cause and lymphoma-related healthcare resource utilization, and costs. The most common comorbidities included chronic pulmonary disease (27.1%), gastroesophageal reflux disease (17.6%), moderate to severe renal disease (16.6%), congestive heart failure (15.7%), and diabetes (15.2%). Average length of stay for inpatient hospitalizations ranged from 6.3 days for CLL to 7.4 days for MCL; the mean costs per hospitalization ranged from $19,566 for CLL to $24,439 for MCL. Non-White patients experienced a significantly longer mean length-of-stay than White patients (CLL, 18.3 vs 14.8; MCL, 21.7 vs 18.3; MZL, 21.6 vs 18.5; WM, 19.0 vs 14.5). Across the four lymphoma types, multivariable regression showed that higher hospitals costs were associated with patients who were non-White, Hispanic/Latino, treated in hospitals in the Northeast or West, or had Medicaid, and a statistically significant higher cost of care was seen for patients treated with targeted therapy or supportive care, such as blood transfusions.