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Research Article
15 December 2023

Real-world use of inotuzumab ozogamicin is associated with lower health care costs than blinatumomab in patients with acute lymphoblastic leukemia in the first relapsed/refractory setting

Authors: Alexander Russell-Smith https://orcid.org/0000-0003-1445-8138, Louise Murphy https://orcid.org/0000-0003-3919-0721 [email protected], Amy Nguyen, Cori Blauer-Peterson, Marilou Terpenning, Feng Cao, Shiqiang Li, Tim Bancroft https://orcid.org/0000-0002-4998-582X, Noah Webb https://orcid.org/0009-0009-8379-2050, Stephanie Dorman https://orcid.org/0009-0009-1391-7794, and Richa Shah https://orcid.org/0009-0005-3771-9283Author Info & Affiliations
Volume 13, Number 2
https://doi.org/10.57264/cer-2023-0142
PDFFormats

Abstract

Aim: To compare all-cause and acute lymphoblastic leukemia (ALL)-related healthcare resource utilization (HCRU) and costs among patients receiving inotuzumab ozogamicin (InO) and blinatumomab (Blina) for ALL in the first relapsed/refractory (R/R) setting. Patients & methods: We studied retrospective claims for adult commercial and Medicare Advantage enrollees with ALL receiving InO (n = 29) or Blina (n = 23) from 1 January 2015 to 16 February 2021. Mean per-patient-per-month (PPPM) HCRU and total costs were described and multivariable-adjusted PPPM total all-cause and ALL-related predicted costs were calculated. Results: Mean monthly ALL-related hospitalizations were the same for patients receiving InO and Blina (PPPM = 0.8 stays); however, the length of ALL-related hospital stay was almost twice as long among patients receiving Blina versus InO (ALL-related: InO = 7.6 days; Blina = 14.1 days; p = 0.346). In multivariable models, total ALL-related costs were 43% lower for InO compared with Blina (PPPM costs: InO = $93,767; Blina = $163,470; p = 0.021). Conclusion: In the first R/R setting, patients who used InO had significantly lower all-cause and ALL-related costs compared with patients who used Blina, in part driven by hospitalization patterns.

Plain language summary

What was this article about?

We studied adults with acute lymphoblastic leukemia, which is a rare type of blood cancer. This cancer frequently returns (relapses) or does not completely go away (refractory), even after cancer treatment. We studied patients who were experiencing relapsed or refractory blood cancer for the first time. Death from this cancer is high. Two newer medications for treating this cancer are inotuzumab ozogamicin and blinatumomab, also known as InO and Blina. Patients who receive these medications have lower death rates. We studied how much patients with this cancer used healthcare services and the costs of these services. We looked at whether there were differences in costs for patients receiving InO compared with Blina, after accounting for differences in characteristics between these two patient groups.

What were the results?

Patients who received InO had shorter stays in the hospital to treat their blood cancer than patients receiving Blina. Patients receiving InO had lower medical costs to treat the blood cancer than patients receiving Blina.

What do the results of the study mean?

Patients who received Blina may have had higher medical costs than patients who received InO because hospitalizations are costly. The results of our study are important for healthcare decision makers who decide which medications have the best value for money. We studied a relatively small number of patients. We do not know if the results of this study apply to all patients with this blood cancer in the same situation. This is one of the first studies to examine these questions. The patterns we found are like earlier studies, which used different scientific approaches. This increases our confidence in the results of this study.

Supplementary Material

File (supplementary data.docx)

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