Healthcare Resource Utilization (HCRU) Analysis in Newly Diagnosed Mantle Cell Lymphoma: Autologous Stem Cell Transplantation (ASCT) and (HCRU) Alleviation With Adoption of the TRIANGLE Ibrutinib Regimen Without (ASCT)
Author(s)
Jonas Wisskirchen, Dr.1, Nora Rogmann, Dr.1, Michael Greiling, Dr.2, Frederic Ries, Dr.1, Anke Ohler, Dr.1, Georg Hess, Dr.1, Julia Osygus, DipBA3.
1Department of Hematology and Medical Oncology, Medical School of the Johannes Gutenberg-University, Mainz, Germany, 2Institute for Workflow-Management in Health Care (IWiG), European University of Applied Sciences, Cologne, Germany, 3Institute for Workflow-Management in Health Care (IWiG), European University of Applied Sciences, Rheine, Germany.
1Department of Hematology and Medical Oncology, Medical School of the Johannes Gutenberg-University, Mainz, Germany, 2Institute for Workflow-Management in Health Care (IWiG), European University of Applied Sciences, Cologne, Germany, 3Institute for Workflow-Management in Health Care (IWiG), European University of Applied Sciences, Rheine, Germany.
OBJECTIVES: In the TRIANGLE study (Dreyling M, et al. Lancet Oncol. 2024;403[10441]:2293-2306) ibrutinib demonstrated clinically meaningful improvements in outcomes compared with high-dose chemotherapy (HDCT) and ASCT (HDCT-ASCT) in patients with newly diagnosed mantle cell lymphoma (MCL) who were eligible for ASCT. Among patients undergoing HDCT-ASCT, approximately 5% are admitted to the intensive care unit, predominantly due to sepsis, with a median hospitalization duration of 30 days (range, 18-51 days). Moreover, mean direct healthcare costs of €107,457 have been reported with HDCT-ASCT for aggressive lymphomas in Germany. The primary objective of this analysis was to determine the impact of omitting HDCT-ASCT on hospitalization duration and HCRU for patients newly diagnosed with MCL.
METHODS: ClipMed® PPM software-based process analysis was used to assess HCRU for ASCT therapy in MCL. Data were sourced from the IWiG® reference model for quantitative activity-based health economic evaluation, and were validated by clinical experts alongside standard operating procedures.
RESULTS: The treatment pathway from assessing ASCT eligibility to 100 days post ASCT involved 1653 processes over 49 patient-clinician interaction days. The HDCT-ASCT phase of the procedure involved 23 days of hospitalization. Healthcare professional services time associated with apheresis and HDCT-ASCT phase—time that could be freed up if the TRIANGLE ibrutinib regimen without ASCT was adopted—totaled 214 hours. This time comprised 24 hours for hematologists, 154 hours for nursing staff, and 36 hours for other functional services (eg, radiology, transfusion medicine, stem cell laboratory, psychology).
CONCLUSIONS: In the treatment of newly diagnosed ASCT-eligible patients with MCL, substituting HDCT-ASCT with an oral treatment, per the TRIANGLE ibrutinib regimen without ASCT, could avoid at least 23 days of hospitalization and liberate substantial healthcare resources.
METHODS: ClipMed® PPM software-based process analysis was used to assess HCRU for ASCT therapy in MCL. Data were sourced from the IWiG® reference model for quantitative activity-based health economic evaluation, and were validated by clinical experts alongside standard operating procedures.
RESULTS: The treatment pathway from assessing ASCT eligibility to 100 days post ASCT involved 1653 processes over 49 patient-clinician interaction days. The HDCT-ASCT phase of the procedure involved 23 days of hospitalization. Healthcare professional services time associated with apheresis and HDCT-ASCT phase—time that could be freed up if the TRIANGLE ibrutinib regimen without ASCT was adopted—totaled 214 hours. This time comprised 24 hours for hematologists, 154 hours for nursing staff, and 36 hours for other functional services (eg, radiology, transfusion medicine, stem cell laboratory, psychology).
CONCLUSIONS: In the treatment of newly diagnosed ASCT-eligible patients with MCL, substituting HDCT-ASCT with an oral treatment, per the TRIANGLE ibrutinib regimen without ASCT, could avoid at least 23 days of hospitalization and liberate substantial healthcare resources.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE508
Topic
Economic Evaluation, Health Service Delivery & Process of Care
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology