Real-World Treatment Patterns and Economic Burden of Marginal Zone Lymphoma

Marginal zone lymphoma (MZL), the second most common indolent non-Hodgkin lymphoma in the US, lacks extensive research on its real-world treatment patterns and economic impact, according to researchers who presented their findings at the 66^th American Society of Hematology Annual Meeting & Exposition. Their retrospective study analyzed treatment trends and associated health care costs for patients with MZL using Optum’s de-identified Clinformatics^® Data Mart Database, covering data from October 2015 to June 2021.

The study included 2,207 patients with newly diagnosed MZL, with an average follow-up of 26 months. Patients had a mean age of 71 years and were predominantly female (53%), and most had insurance coverage by Medicare Advantage (75%). Cardiovascular disease (31%) and chronic obstructive pulmonary disease (26%) were the most common comorbidities. Lines of therapy (LOTs) were evaluated in a subset of 510 patients, with 23% undergoing at least two LOTs and 7% receiving three or more.

Rituximab monotherapy was the most used treatment in all lines, accounting for 48% in the first line (1L), 34% in the second line (2L), and 51% in the third line or beyond (3L+). Bendamustine-based therapies were also prevalent in 1L (24%) and 2L (21%). Ibrutinib-based therapies saw increased utilization in 2L (13%) and 3L+ (16%).

Patients averaged 2.4 outpatient visits, 0.06 inpatient visits, 0.05 emergency department visits, and 0.19 other visits per patient-month. MZL-related visits comprised less than one-third of total visits across settings.

• All-cause costs averaged $9,580 per patient per month, with 95% being medical expenses.
• Inpatient costs ($5,132) were the largest contributor to medical expenses, followed by outpatient costs ($3,630).
• Costs peaked in 2L, with outpatient visits dominating in 1L and 2L, and inpatient costs were highest in 3L+.
• Pharmacy costs were lowest in 1L and highest in 2L.

“The current study describes treatment patterns and economic burden among MZL patients in the US,” concluded the authors of the study. “Results show that rituximab monotherapy is highly utilized across LOTs, but that bendamustine- and ibrutinib-based therapies are also common. MZL has a high economic burden, driven by medical costs across LOTs, emphasizing an area of unmet need.”

REFERENCE

Garg M, Satija A, Song Y, et al. A retrospective claims analysis of real-world treatment patterns and economic burden among patients with marginal zone lymphoma in the US. Abstract #5104. Presented at the American Society of Hematology Annual Meeting; December 7-10, 2024; San Diego, California.