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) mantle cell lymphoma (MCL) in the US.

METHODS: Adult patients with newly diagnosed (index) MCL were identified using IBM MarketScan^® claim databases between 11/13/2013 and 12/31/2017. Patients were required to have at least 6 months of continuous enrollment pre-index and no pre-index evidence of other primary malignancies, antineoplastic agents, or hematopoietic stem-cell transplantation. Baseline demographic and clinical characteristics as well as mean per-patient-per-month (PPPM) HRU and mean monthly cost difference (MMCD) were compared for ibrutinib- and CIT-treated patients in 1L and 2L in the follow-up period.

RESULTS: 1L and 2L cohorts had 40 and 22 ibrutinib-treated, and 253 and 38 CIT-treated patients, respectively. Mean follow-up times stratified by 1L were 801 days for ibrutinib and 528 days for CIT. Both cohorts had comparable baseline characteristics across lines. CIT-treated 1L patients had higher inpatient visits (0.1 vs. 0.03, P<0.05) and outpatient services (3.65 vs. 1.96, P<0.01), mainly driven by other outpatient services including antineoplastic-drug-administration–related visits. Compared to CIT-treated patients, 1L ibrutinib-treated patients had lower medical costs which fully offset higher pharmacy costs, resulting in a significant net-monthly-total-cost reduction of $6,723 (P<0.01). 2L HRU and medical cost findings were similar. The $4,619 (P<0.01) lower outpatient PPPM costs and $2,032 (P<0.01) higher pharmacy PPPM costs for ibrutinib-treated patients resulted in an overall net-monthly-total-cost of $2,761 lower for ibrutinib compared to CIT, but this difference was statistically insignificant in 2L patients with MCL.

CONCLUSIONS: Ibrutinib was associated with lower healthcare resource utilization compared to chemoimmunotherapy in patients with MCL. Higher ibrutinib pharmacy costs were fully offset by lower medical costs mainly driven by outpatient cost differential resulting in net-total-cost reduction compared to chemoimmunotherapy. FUNDING: Pharmacyclics LLC, an AbbVie Company.