Economic burden and treatment patterns among patients with mantle cell lymphoma in the United States: a retrospective study of administrative claims data.

Objective: Mantle cell lymphoma (MCL) is a rare, aggressive form of non-Hodgkin's lymphoma with relatively poor prognosis. The economic burden of MCL warrants further evaluation, especially given an evolving treatment landscape. This study describes current treatment patterns and economic outcomes among patients with MCL in the United States.

Methods: This retrospective cohort study identified adult patients with MCL from claims data (October 2015- March 2021). Outcomes included treatment patterns by line of therapy (LOT), monthly healthcare resource use (HRU) rates, and healthcare costs per patient per month (PPPM) overall and in first line (1 L), second line (2 L), third line (3 L), and beyond (3 L+).

Results: The study included 696 patients with MCL (mean follow-up: 22 months; mean age: 71 years; 68% male). Bendamustine-based therapies were most common in 1 L (49%), followed by rituximab monotherapy (14%) and R-CHOP (13%). Rituximab monotherapy and ibrutinib-based therapies were the most common in 2 L (27%; 25%) and 3 L (33%; 21%). During follow-up, MCL-related visits accounted for most hospitalizations (69.2%) and >80% of total all-cause costs ($21,477/$25,944 PPPM). Mean total all-cause costs PPPM increased across lines (1 L: $29,301; 2 L: $34,667; 3 L+: $41,423) due to rising MCL-related medical costs (1 L: $23,859; 2 L: $27,933; 3 L+: $33,399). MCL-related hospitalization costs accounted for higher proportions of MCL-related medical costs with increasing LOTs (51.1% in 1 L to 70.0% in 3 L+).

Conclusions: Although a range of treatments are used to manage MCL, including targeted therapies such as ibrutinib, there is a high HRU and cost burden driven by disease-related medical costs that increase with subsequent LOTs.