CLINICAL CHARACTERISTICS, TREATMENT PATTERNS, AND HEALTHCARE COSTS OF DIFFUSE LARGE B-CELL LYMPHOMA IN COLOMBIA: A REAL-WORLD EVIDENCE STUDY
Author(s)
Jorge Anibal Daza, MD1, Abello Virginia, MD1, Natalia Sánchez, MD2, Juan David Bahena, Econ MBA3, Olga Paola Omaña, MD1, Carlos Fernando Gomez, MD1, Adriana Aya Porto, RN2, Nicolas Rozo, MD MSc4, Claudia Hernández-Castillo, RN MSc4, Daniel Samaca, BS MSc4, Melissa Diaz Puentes, MSc, MD4, Mauricio Hernandez, MD MSc5, Laura Prieto, MD MSc4, Andrés Cardona, MD2;
1Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (CTIC), Functional clinical unit for Leukemia, Lymphoma and Myeloma, Bogotá, Colombia, 2Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (CTIC), Institute of Research, Science and Education, Bogotá, Colombia, 3Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (CTIC), Business Intelligence Area, Bogotá, Colombia, 4Roche, Evidence Generation, Bogotá, Colombia, 5Roche, Medical Affairs, Bogotá, Colombia
1Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (CTIC), Functional clinical unit for Leukemia, Lymphoma and Myeloma, Bogotá, Colombia, 2Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (CTIC), Institute of Research, Science and Education, Bogotá, Colombia, 3Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (CTIC), Business Intelligence Area, Bogotá, Colombia, 4Roche, Evidence Generation, Bogotá, Colombia, 5Roche, Medical Affairs, Bogotá, Colombia
OBJECTIVES: To describe the clinical characteristics of patients with diffuse large B-cell lymphoma (DLBCL) treated at a reference cancer center in Colombia and to assess the association between clinical variables and direct healthcare management costs.
METHODS: A retrospective observational study was conducted between July 2022 and September 2025. Patients with DLBCL treated at the CTIC were included. Clinical data were obtained from the CTIC registry and linked to healthcare resource utilization (HRU) and cost databases. Direct costs were estimated from HRU and reported as median monthly costs per treatment line. Multivariable regression models used direct costs as the dependent variable, with R-IPI score and PET/CT response as independent variables, adjusting for sex, treatment line, insurance regime, and comorbidities. Costs are reported in 2025 USD (1USD=4,063COP).
RESULTS: Sixty-nine patients were included; 76.6% presented with advanced-stage disease (Ann Arbor III-IV). Rituximab-CHOP were the most frequently administered treatment in first-line (1L) and R-platinum based for relapse/refractory (R/R). Relapse rates were 10.9% in 1L and 14.3% in second-line (2L). No statistically significant association was observed between baseline R-IPI score and costs. Median monthly costs were more than 2-fold higher in third-line (n=4; USD6,513) and 2L (n=21; USD7,337) than in 1L (n=64; USD2,754). In 1L, refractory disease on PET/CT was associated with 7.6-fold higher costs compared with complete response (CR). Patients who died before PET/CT evaluation (n=10) incurred 7.2-fold higher costs than those achieving CR.
CONCLUSIONS: Most DLBCL patients were diagnosed at advanced stages and received rituximab-CHOP in first-line and R-platinum based in second-line settings, reflecting current clinical practice. R/R disease and suboptimal response to initial therapy were associated with substantially higher costs in subsequent lines of treatment. These findings underscore the importance of earlier diagnosis and optimizing disease control in first-line to reduce progression and mitigate the high direct costs associated with advanced care.
METHODS: A retrospective observational study was conducted between July 2022 and September 2025. Patients with DLBCL treated at the CTIC were included. Clinical data were obtained from the CTIC registry and linked to healthcare resource utilization (HRU) and cost databases. Direct costs were estimated from HRU and reported as median monthly costs per treatment line. Multivariable regression models used direct costs as the dependent variable, with R-IPI score and PET/CT response as independent variables, adjusting for sex, treatment line, insurance regime, and comorbidities. Costs are reported in 2025 USD (1USD=4,063COP).
RESULTS: Sixty-nine patients were included; 76.6% presented with advanced-stage disease (Ann Arbor III-IV). Rituximab-CHOP were the most frequently administered treatment in first-line (1L) and R-platinum based for relapse/refractory (R/R). Relapse rates were 10.9% in 1L and 14.3% in second-line (2L). No statistically significant association was observed between baseline R-IPI score and costs. Median monthly costs were more than 2-fold higher in third-line (n=4; USD6,513) and 2L (n=21; USD7,337) than in 1L (n=64; USD2,754). In 1L, refractory disease on PET/CT was associated with 7.6-fold higher costs compared with complete response (CR). Patients who died before PET/CT evaluation (n=10) incurred 7.2-fold higher costs than those achieving CR.
CONCLUSIONS: Most DLBCL patients were diagnosed at advanced stages and received rituximab-CHOP in first-line and R-platinum based in second-line settings, reflecting current clinical practice. R/R disease and suboptimal response to initial therapy were associated with substantially higher costs in subsequent lines of treatment. These findings underscore the importance of earlier diagnosis and optimizing disease control in first-line to reduce progression and mitigate the high direct costs associated with advanced care.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
CO67
Topic
Clinical Outcomes
Topic Subcategory
Clinical Outcomes Assessment
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Oncology