New Study Confirms Economic Burden of Chronic Lymphocytic Leukemia on Medicare Beneficiaries

Chronic lymphocytic leukemia (CLL) is a type of blood cancer and the most common type of leukemia. It mainly affects older adults; the average age at CLL diagnosis is 70 years. In 2023, more than 18,000 people were diagnosed with CLL and nearly 4,500 people died from it, according to American Cancer Society estimates.

Survival rates for blood cancers have improved due to the availability of better treatments, including targeted therapies like tyrosine kinase inhibitors (TKIs). For instance, the five-year survival rate for a different type of leukemia, chronic myeloid leukemia, has gone up from 22% in the mid-1970s to 70% for those diagnosed from 2012-2018. And patients treated with TKIs are now living close to a normal lifespan, on average.

Because treating CLL and other blood cancers can be expensive, researchers have investigated treatment costs and related healthcare utilization. One past study looked at different treatments and found that Imbruvica (ibrutinib), a TKI indicated for CLL among other conditions, was cheaper overall. Another study found that Imbruvica costs less per month than chemoimmunotherapy when used first. Also, where treatment is received can make a difference in cost. For instance, receiving a medication infusion in a hospital typically costs more than getting the same infusion at a doctor's office.

A new study published May 2024 in the Journal of Managed Care & Specialty Pharmacy examined the costs and healthcare resource utilization among Medicare beneficiaries diagnosed with CLL. In this study by Ebere Onukwugha, Ph.D. and colleagues, the average costs of care, factors impacting costs and the distribution of costs across different care settings were analyzed. The study was supported by BeiGene, Ltd.

The study used Medicare data to analyze economic outcomes for individuals with CLL compared to those without CLL. They matched cohorts based on baseline variables and analyzed total costs and types of healthcare services used. They used regression models to identify factors associated with healthcare resource utilization.

The research included Medicare beneficiaries diagnosed with CLL between 2017 and 2019. There were 2,736 beneficiaries in the CLL cohort and 13,571 beneficiaries in the non-CLL matched cohort.

The analysis found that the average annual total costs for individuals with CLL were significantly higher compared to a matched non-CLL cohort. Overall, the average total cost among beneficiaries with CLL was 63% higher (or an increased cost of $8,880), compared to the average total cost among beneficiaries without CLL.

The costs were mainly driven by hospital outpatient, healthcare provider and prescription drug costs. Beneficiaries who received infusion medications as initial treatment had higher costs associated with provider and hospital services, while those prescribed oral treatments had higher Part D prescription costs.

Furthermore, the study identified several predictors for healthcare costs and their average marginal effects among beneficiaries diagnosed with CLL. Factors such as male sex, low income, poor performance or frailty status, and more comorbidities were associated with higher total costs and costs across various points of care.

“The information presented can be used to guide clinicians, payers and policymakers to outline programming strategies designed to lower the cost burden among vulnerable subgroups of beneficiaries,” the authors wrote in the conclusion of their paper.