Healthcare cost and utilization for chimeric antigen receptor (CAR) T-cell therapy in the treatment of pediatric acute lymphoblastic leukemia: A commercial insurance claims database analysis.
Healthcare cost and utilization for chimeric antigen receptor (CAR) T-cell therapy in the treatment of pediatric acute lymphoblastic leukemia: A commercial insurance claims database analysis.
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嵌合抗原受体 (CAR) T 细胞疗法治疗儿童急性淋巴细胞白血病的医疗费用和利用：商业保险索赔数据库分析。
DOI：
10.1002/cnr2.1980
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发表时间：
2024
期刊：
影响因子：
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通讯作者：
Turcotte,LucieM
中科院分区：
文献类型：
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作者：
Hoover,Alex;Reimche,Paige;Watson,Dave;Tanner,Lynn;Gilchrist,Laura;Finch,Mike;Messinger,YoavH;Turcotte,LucieM
背景B-系急性淋巴细胞白血病（B-ALL）是儿童最常见的恶性肿瘤。随着新型细胞疗法的引入，护理成本是一个关键组成部分，患者和社会所承受的经济负担需要评估。本研究旨在评估嵌合抗原受体T细胞（CAR-T）治疗在美国有商业保险的儿童ALL患者中的利用率和护理成本。方法和结果使用OptumLabs®数据仓库中的去识别商业保险数据，确定了2016年10月至2021年12月期间在美国接受CAR-T治疗的37例1 - 25岁B-ALL患者队列。在90天的时间内，包括CAR-T输注以及给药和并发症特征，对成本进行了评估。在确定的37例接受CAR-T产品输注的B-ALL患者中，14例患者为女性，给药时的中位年龄为13岁。90天总成本中位数为620，500（平均值：589，108）。住院费用约占总费用的71%，平均每名患者住院28天。尽管老年组（10 - 25岁）和细胞因子释放综合征（CRS）患者的住院费用略高，但这些差异无统计学意义。结论这一真实的世界成本分析首次显示了在美国有商业保险的儿童B-ALL患者中CAR-T治疗的涵盖成本。这项研究提供了一个有价值的基准，可用于分析CAR-T治疗对卫生系统儿科B-ALL治疗的财务影响。
Background B‐lineage acute lymphoblastic leukemia (B‐ALL) is the most common malignancy of childhood. With the introduction of novel cellular therapies, cost of care is a critical component and the financial burden experienced by patients and society requires evaluation. Aims This study aims to assess the utilization and cost of care for chimeric antigen receptor T‐cell (CAR‐T) therapy for pediatric ALL patients with commercial insurance coverage in the United States. Methods and Results Using de‐identified commercial insurance data from the OptumLabs® Data Warehouse, a cohort of 37 patients, aged 1‐25 years, with B‐ALL treated with CAR‐T therapy between Oct 2016 and Dec 2021 in the United States was identified. Cost was evaluated for a 90 day period encompassing CAR‐T infusion and by administration and complication characteristics. Among the 37 identified B‐ALL patients that received a CAR‐T product infusion, 14 patients were female, median age at administration was 13 years. The median 90‐day total cost was 620,500(Mean: 589,108). Inpatient cost accounted for approximately 71% of the total cost with an average of 28 inpatient days per patient. Although inpatient cost was slightly higher in the older age group (aged 10‐25 years) and in patients with a code for cytokine release syndrome (CRS), these differences were not statistically significant. Conclusion This real‐world cost analysis shows for the first time the encompassing cost of CAR‐T therapy for pediatric B‐ALL patients in the US with commercial insurance. This study provides a valuable benchmark that can be used to analyze the financial implications of CAR‐T therapy for pediatric B‐ALL therapy on health systems.