Assessing Costs and Resource Utilization of Hospital-Based Care Among Patients with B-Cell Malignancies

Patients with mantle cell lymphoma (MCL), Waldenström macroglobulinemia (WM), marginal zone lymphoma (MZL), and chronic lymphocytic leukemia (CLL) have high hospital costs associated with disease relapse, especially among minority populations, according to a study conducted by Asher Chanan-Khan, MBBS, MD, and colleagues. The findings were presented at the 2021 American Society of Hematology Annual Meeting.

In this retrospective study, researchers utilized the Premier Healthcare Database to assess 23,952 CLL, 3,387 MCL, 2,655 MZL, and 1,811 WM patients in the U.S. hospital database. The population of interest were at least 18 years of age, with at least one inpatient or two hospital-based outpatient visits, and who received treatment for their conditions from January 2014 to October 2019. The researchers used descriptive analysis to assess patient sociodemographic and hospital characteristics, all-cause and lymphoma-related healthcare resource utilization, and costs. Costs were procured using patients’ discharge files and hospital billing records.

According to the results, the average length of stay (LOS) of inpatient hospitalization ranged from 6.3 days for CLL to 7.4 days for MCL. Mean costs per hospitalization ranged from $19,566 (CLL) to $24,439 (MCL). The study found that non-White patients have markedly longer average LOS days compared with white patients:

• CLL: 18.3 vs. 14.8
• MCL: 21.7 vs. 18.3
• MZL: 21.6 vs. 18.5
• WM: 19.0 vs. 14.5

Across the four lymphoma types, analysis showed that higher hospitals costs were correlated with patients who were non-White, Hispanic/Latino, treated in hospitals located in the Northeast or West, or had Medicaid. The investigators noted statistically significant increased costs of care for patients who received targeted therapy or supportive care, such as blood transfusions.

“Real-world data demonstrated the significantly high total hospital costs once patients with MCL, WM, MZL, and CLL patients were hospitalized, with significantly higher impact to minority populations,” the researchers concluded. They added that future studies “are needed to explore the reason for admission, clinical outcomes, and potential preventive interventions.”