Continuation of systemic treatments and outcomes for patients with chronic graft-versus-host disease in the USA

Immunotherapy. 2021 Apr;13(5):387-395. doi: 10.2217/imt-2020-0310. Epub 2021 Jan 28.

Abstract

Aim: To compare secondary systemic treatment (SST) continuation and associated resource use and costs in chronic graft-versus-host disease (cGvHD) patients in the USA. Materials & methods: This was a retrospective study using Truven Health MarketScan database (2009-2016). cGvHD patients were classified as continuers or discontinuers if treated with SST for ≥180 days without or with a treatment gap (≥45 days), respectively. Results: Among 464 cGvHD patients with SST, mTOR inhibitors, extracorporeal photopheresis and imatinib were most frequently used. A total of 172 patients were SST continuers and 292 were discontinuers. Extracorporeal photopheresis treated patients were the highest continuers, followed by imatinib and mTOR inhibitors. SST continuers had lower monthly hospitalization costs versus discontinuers. Conclusion: This real-world analysis demonstrates high SST continuation rates in cGvHD patients are associated with lower resource utilization and cost.

Keywords: cGvHD; graft-versus-host disease; healthcare resource use; real-world data; secondary systemic treatment; treatment continuation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Chronic Disease
  • Female
  • Graft vs Host Disease / drug therapy*
  • Graft vs Host Disease / economics
  • Graft vs Host Disease / epidemiology
  • Health Care Costs
  • Health Resources / economics
  • Humans
  • Imatinib Mesylate / therapeutic use
  • Insurance Claim Review
  • MTOR Inhibitors / therapeutic use
  • Male
  • Medication Adherence / statistics & numerical data*
  • Middle Aged
  • Outcome Assessment, Health Care / economics
  • Outcome Assessment, Health Care / statistics & numerical data*
  • Photopheresis
  • Retrospective Studies
  • Time-to-Treatment / statistics & numerical data
  • United States / epidemiology

Substances

  • MTOR Inhibitors
  • Imatinib Mesylate