OBJECTIVES: Compare all-cause healthcare resource utilization (HRU) and costs between single-agent ibrutinib and chemoimmunotherapy (CIT) in patients with first-line (1L) and second-line (2L) WM in the US.

METHODS: Adult patients with newly diagnosed (index) WM were identified using IBM MarketScan^® claim databases between 12/31/2013 and 12/31/2017. Patients were required to have at least 6 months of continuous enrollment pre-index and no evidence of other primary malignancies, antineoplastic agents, or hematopoietic stem-cell transplantation pre-index. Baseline demographic and clinical characteristics as well as differences in mean per-patient-per-month (PPPM) all-cause HRU and mean monthly cost difference (MMCD) between ibrutinib-treated and CIT-treated patients were examined by 1L and 2L in the follow-up period. Sensitivity analyses evaluating WM-specific HRU and costs were conducted.

RESULTS: 1L and 2L cohorts had 44 and 22 ibrutinib-treated, and 80 and 22 CIT-treated patients, respectively. Mean follow-up times were 703 days for ibrutinib-treated and 627 days for CIT-treated patients. Both cohorts had comparable baseline characteristics across lines. Ibrutinib-treated 1L patients had less than half the number of outpatient service visits (6.5 vs. 13.8, P<0.01), due to fewer outpatient services including antineoplastic-drug-administration–related visits (5.5 vs. 12.7, P<0.01), resulting in a net-monthly-outpatient-cost decrease of $7,424 (P<0.001) compared to CIT-treated patients. HRU and cost findings were similar in 2L. Fewer outpatient services (4.0 vs. 9.9, P<0.01) associated with ibrutinib, due to lower other outpatient services (3.5 vs. 9.0, P<0.01), had a corresponding significant decrease in outpatient costs of $4,264 (P<0.001) compared to CIT. Despite higher pharmacy costs, ibrutinib-treated patients had lower overall net-monthly-total-cost ($2,617 in 1L and $761 in 2L) compared to CIT-treated patients (statistically insignificant). WM-specific findings were similar across both lines.

CONCLUSIONS: Ibrutinib-treated patients had significantly lower all-cause and WM-specific outpatient healthcare resource utilization and costs compared to chemoimmunotherapy-treated patients in first- and second-line. FUNDING: Pharmacyclics LLC, an AbbVie Company.