OBJECTIVES:

We examined treatment patterns, HRU, and costs for patients receiving CAR-T and/or MABs for R/R LBCL.

METHODS:

We calculated: all-cause and non-CAR T-related (i.e., all-cause minus CAR T) HRU and costs for CAR T patients; all-cause HRU and costs for MAB patients. HRU and costs were mean per-patient-per-month during 6-month follow-up. For CAR T and MAB, follow-up started on CAR T infusion and first MAB claim date respectively. The sample comprised adult patients who had: CAR T and/or MAB (7/2017-10/2021); ≥ 90 days continuous enrolment before index; ≥ 1 LBCL diagnosis claim; and no pregnancy.

RESULTS:

A total of 195 patients had identified CAR T products: axicabtagene ciloleucel (axi-cel) (n=137), tisagenlecleucel (tisa-cel) (n=49), lisocabtagene maraleucel (liso-cel) (n=9). Axi-cel group had highest proportion of commercially insured patients. Mean Charlson scores were axi-cel=3.8, tisa-cel=4.0, and liso-cel=2.4. Median days from leukapheresis to CAR T infusion (n=126): axi-cel=26.0, tisa-cel=35.0, and liso-cel= 37.0. Number of all-cause (non-CAR T) ambulatory visits: axi-cel=9.73 (9.63), tisa-cel=11.76 (11.48), liso-cel= 13.60 (13.22). Number of all-cause (non-CAR T) inpatient (IP) days: axi-cel=5.91 (1.86), tisa-cel=5.41 (2.01), liso-cel=2.73 (0.22). Total all-cause (non-CAR T) costs: axi-cel= $133,139 ($24,012), tisa-cel=$101,946 ($33,276), liso-cel=$127,567 ($77,850); all-cause (non-CAR T) ambulatory cost: axi-cel=$15,995 ($12,619), tisa-cel=$24,185 ($23,869), liso-cel=$76,693 ($76,622); all-cause (non-CAR T) IP stays costs: axi-cel=$96,855 ($8,110), tisa-cel=$70,915 ($7,181), liso-cel=$50,121 ($475). During the study period, 28.7% and 8.9% of Pola (n=188) and Tafa (n=56) received CAR T. In the MAB groups, number of all-cause (including MABs) ambulatory visits were: polatuzumab vedotin-piiq (pola)=8.7, tafasitumab-cxix (tafa)=9.4; IP days: pola=2.24, tafa=2.25; and all-cause costs: pola=$49,792, tafa=$25,978. Subgroup and multivariable analyses will be presented.

CONCLUSIONS:

Time from leukapheresis to infusion was shortest for axi-cel. Compared with other CAR T products, axi-cel had higher all-cause but lower non-CAR T costs. MAB use was common among CAR T patients, with substantial HRU and cost impact.