Burden of Diffuse Large B-Cell Lymphoma (DLBCL) in Germany – A Retrospective Statutory Health Insurance Claims Data Analysis

OBJECTIVES: For diffuse large B-cell lymphoma (DLBCL) limited information on epidemiology, hospitalisation, costs, and outcomes in Germany (inpatient/ outpatient) has been published. Objective of this study was to provide information to fill aforementioned gaps.

METHODS: This retrospective cohort study (2015-2020) is based on anonymized, longitudinal German statutory health insurance (SHI) claims data, [InGef database; the sample (size: ~3.3Mio) is representative for the German population]. Inclusion criteria: ≥18 years, inpatient/ outpatient diagnosis DLBCL (ICD C83.3).

RESULTS: The absolute number of prevalent DLBCL patients was n=1.437 in 2020; n=1.205 patients in 2015. In this cohort the relative prevalence was 44,6 per 100.000 in 2020; 36,8/100.000 in 2015. Mean age was 68,6 years (SD±13,6), 55,6% male. About 78% of the patients were hospitalized, 3 (SD±3) mean annual admissions, mean 29,3 inpatient days per patient (ppt; ±47,5). Mean annual costs in 2020 were €24.101 ppt (median 10.964; range 0 – 591.068). The mean documented mortality was 14% per year. A subgroup of 114 patients received a stem-cell-transplant (SCT). Mean age of this subgroup was 59 years (SD±11,6), 63% male. In a 12-months (12m) follow-up period after SCT mean 4 admissions (SD±3) and 96 inpatient days ppt (SD±89) were documented. Mean SCT related 12m costs: €75.675 ppt (45.276; 12.596 – 438.031). The mortality after 12m: 5.3%.

CONCLUSIONS: Wide cost ranges reflect the heterogeneity of the prevalent DLBCL cohort. As first-line R-CHOP-therapy is associated with cure-rates of approx. 60%, follow-up costs are low. Therefore, mean total costs do not appropriately describe payers economic burden. Refractory or relapsed patients require further intensive treatment, e.g. additional lines of therapy, SCT. Comprehensive analyses of more granular sources on clinical information (treatment line, tumour stage) are needed.