Real-World Treatment Patterns, Healthcare Resource Use, and Costs in Patients with Follicular Lymphoma, Waldenström Macroglobulinemia, and Marginal Zone Lymphoma: A Claims-Based Study in the USA.

BACKGROUND AND OBJECTIVES: Indolent non-Hodgkin's lymphomas (NHL) are associated with relapses necessitating recurrent treatment and lifelong care. However, contemporary real-world evidence of the disease burden among patients with indolent NHLs remains limited. This study describes treatment patterns, healthcare resource use (HRU), and costs among patients with follicular lymphoma (FL), Waldenström macroglobulinemia (WM), and marginal zone lymphoma (MZL) in the USA. METHODS: Adults with newly diagnosed FL, WM, and MZL were identified in claims data (October 2015-June 2021). The study period spanned from the index date (first observed diagnosis code) until end of continuous enrollment or data availability. Treatment patterns were described during the study period by lines of therapy (LOTs). HRU and costs per-patient-per-month (PPPM) were described overall and by LOTs. RESULTS: This study included 2805 patients with FL, 791 with WM, and 2207 with MZL with a median follow-up of > 20 months each. Bendamustine-based therapies and rituximab monotherapy were most common. In later lines, bendamustine-based therapies declined while rituximab monotherapy and ibrutinib-based therapies increased. Mean all-cause total costs were US $12,402, US $8445, and US $9580 PPPM for patients with FL, WM, and MZL, respectively. Disease-related medical costs constituted > 50% of all-cause total costs, with most hospitalization costs being disease-related. In FL, HRU and costs tended to increase by LOT, driven by FL-related hospitalizations. Trends in HRU and costs across LOTs were less clear for WM and MZL. CONCLUSIONS: Our study suggests that indolent NHLs are associated with a significant economic burden that tends to increase across LOTs in FL, highlighting the need for better therapeutic options.