OBJECTIVES: To assess treatment patterns and healthcare costs amongst patients diagnosed with diffuse large B-cell lymphoma (DLBCL), particularly during latter stages of therapy.

METHODS: This was a retrospective analysis of the Truven MarketScan^® databases. Study eligibility criteria: 1) diagnosis of DLBCL, 2) ≥ 1 claim for DLBCL treatment in accordance with National Comprehensive Cancer Network guidelines, 3) 12+ months of pre-DLBCL continuous enrollment, 4) absence of other primary or secondary cancers in the 12-month pre-period (excluding lymphomas), 5) absence of DLBCL treatments in the 12-month pre-period, and 6) 18+ years of age at diagnosis. Outcomes included the frequency of specific regimens by line of therapy (LOT), and total healthcare costs associated with each regimen. Chemotherapy regimen analyses were conducted from the point of treatment initiation until the discontinuation of all agents, while autologous and allogenic stem-cell transplantations (SCT) were assessed for 30 days following the procedure.

RESULTS: A total of 1,625 patients qualified for the study with 81.9% receiving 1 LOT, 14.3% receiving 2 LOTs, and 3.8% with ≥ 3 LOTs. The most common 1^st line treatment was rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP; 66.5%), while the most common 2^nd and 3^rd line treatments (n=294) included SCT (2^nd LOT (16.0%) and 3^rd LOT (27.9%)). Mean healthcare expenditure during 1^st LOT was $82,693 over a 90.0±50.6-day course; while 2^nd LOT costs for only the SCT-related services were $164,460, with non-SCT treatment costs of $58,878 over 65.4±59.4 days. Similarly, 3^rd LOT costs for only the SCT-related services were $127,295, with non-SCT treatment costs of $58,311 over 69.1±58.4 days.

CONCLUSIONS: Costs of subsequent treatments are significantly greater among those who undergo both chemotherapy and SCT ($223,338 and $185,606 for 2^nd and 3^rd LOT, respectively). Such costs are likely underestimated when considering the downstream costs that are incurred after completion of treatment.