Assessing the economic burden of Waldenström’s Macroglobulinemia (WM), Marginal Zone Lymphoma (MZL), and Chronic Lymphocytic Leukemia (CLL)
DOI:
https://doi.org/10.33393/grhta.2025.3365Keywords:
Direct costs, Economic Burden, Waldenström’s Macroglobulinemia (WM), Marginal Zone Lymphoma (MZL), Chronic Lymphocytic Leukemia (CLL), indirect costs, Italy, Real-World EvidenceAbstract
Introduction: In Italy, Non-Hodgkin Lymphomas (NHL), including Waldenström’s Macroglobulinemia (WM), Marginal Zone Lymphoma (MZL), and Chronic Lymphocytic Leukemia (CLL), are among the most common hematologic cancers. These conditions mainly affect the elderly, who often have multiple comorbidities, complicating management and imposing significant burdens on patient quality of life and healthcare systems.
Objective: This study aimed to estimate the economic burden of selected B-cell lymphomas in Italy, providing insights for decision-makers to improve patient management and resource allocation.
Method: Data from the Italian Hospital Discharges Records (SDO) and the National Institute for Social Security were analyzed to estimate direct healthcare costs and social security costs from 2016 to 2019.
Results: A total of 93,712 hospital discharges were recorded, with MZL being the most common diagnosis, followed by CLL and WM. Most patients were male, and the 70–79 age group was most prevalent. MZL had the highest costs, followed by CLL and WM. Adverse events notably increased total expenditures, with variations across different pathologies. Direct healthcare costs totaled 533.6 million euros, while social security costs amounted to 240.9 million euros.
Conclusion: This study highlights the significant economic burden of selected B-cell lymphomas in Italy. Effective management strategies are crucial for reducing costs and optimizing resource allocation in the healthcare system.
Downloads
References
Thandra KC, Barsouk A, Saginala K, et al. Epidemiology of Non-Hodgkin’s Lymphoma. Vol. 9, Medical sciences (Basel, Switzerland). 2021. DOI: 10.3390/medsci9010005
Mafra A, Laversanne M, Gospodarowicz M, et al. Global patterns of non-Hodgkin lymphoma in 2020. Int J Cancer. 2022;151(9):1474–1481. DOI: https://doi.org/10.1002/ijc.34163 PMID:35695282
AIOM AIRTUM. I numeri del cancro in Italia 2023. 2023 Online https://www.aiom.it/i-numeri-del-cancro-in-italia/ (Accessed October 2024)
Castillo JJ, Olszewski AJ, Cronin AM, et al. Survival trends in Waldenström macroglobulinemia: an analysis of the Surveillance, Epidemiology and End Results database. Blood. 2014;123(25):3999–4000. DOI: https://doi.org/10.1182/blood-2014-05-574871 PMID:24948623
Buske C, Leblond V, Dimopoulos M, Kimby E, Jäger U, Dreyling M. Waldenström’s macroglobulinaemia: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2013;24(SUPPL.6). DOI: 10.1093/annonc/mdt298
Smith A, Crouch S, Lax S, et al. Lymphoma incidence, survival and prevalence 2004-2014: sub-type analyses from the UK’s Haematological Malignancy Research Network. Br J Cancer. 2015;112(9):1575–1584. DOI: https://doi.org/10.1038/bjc.2015.94 PMID:25867256
Li S, Liu J, Bowers C, et al. Febrile neutropenia-related care and associated costs in elderly patients with breast cancer, lung cancer, or non-Hodgkin lymphoma. Support Care Cancer. 2020;28(1):113–122. DOI: https://doi.org/10.1007/s00520-019-04795-0 PMID:30993450
Kenzik KM, Mehta A, Richman JS, et al. Congestive heart failure in older adults diagnosed with follicular lymphoma: A population-based study. Cancer. 2018;124(21):4221–4230. DOI: https://doi.org/10.1002/cncr.31695 PMID:30303522
Kenzik KM, Williams GR, Bhakta N, et al. Healthcare utilization and spending among older patients diagnosed with Non-Hodgkin lymphoma. J Geriatr Oncol. 2021;12(8):1225–1232. DOI: https://doi.org/10.1016/j.jgo.2021.06.006 PMID:34176753
Zakeri M, Li J, Sansgiry SS, et al. Incremental health care expenditures for non-Hodgkin lymphoma in comparison with other cancers: analysis of national survey data. J Manag Care Spec Pharm. 2023;29(5):480–489. DOI: https://doi.org/10.18553/jmcp.2023.29.5.480 PMID:37121258
Mounie M, Costa N, Conte C, et al. Costs of Hodgkin and Non-Hodgkin Lymphoma in France: Results on the Basis of the French National Health Insurance Database. Value Health. 2018;21:S25. DOI: https://doi.org/10.1016/j.jval.2018.04.157
Zucca E, Arcaini L, Buske C, et al; ESMO Guidelines Committee. Electronic address: clinicalguidelines@esmo.org. Marginal zone lymphomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2020;31(1):17-29. https://doi.org/10.1016/j.annonc.2019.10.010 PMID:31912792
Ardeshna KM, Smith P, Norton A, et al; British National Lymphoma Investigation. Long-term effect of a watch and wait policy versus immediate systemic treatment for asymptomatic advanced-stage non-Hodgkin lymphoma: a randomised controlled trial. Lancet. 2003;362(9383):516–522. DOI: https://doi.org/10.1016/S0140-6736(03)14110-4 PMID:12932382
Ministero della Salute. Il flusso informativo SDO. Online https://www.salute.gov.it/portale/assistenzaOspedaliera/dettaglioContenutiAssistenzaOspedaliera.jsp?lingua=italiano&id=1232&area=ricoveriOspedalieri&menu=rilevazione (Accessed October 2024)
INPS. Osservatorio sulle pensioni erogate dall’INPS. Online https://servizi2.inps.it/servizi/osservatoristatistici/6 (Accessed October 2024)
Russo S, Mariani TT, Migliorini R, et al. The economic burden of musculoskeletal disorders on the Italian social security pension system estimated by a Monte Carlo simulation. Reumatismo. 2015;67(2):45–56. DOI: https://doi.org/10.4081/reumatismo.2015.811 PMID:26492962
Cerhan JR, Habermann TM. Epidemiology of marginal zone lymphoma. Ann Lymphoma. 2021;5:5. DOI: https://doi.org/10.21037/aol-20-28 PMID:33829216
Sant M, Minicozzi P, Mounier M, et al; EUROCARE-5 Working Group. Survival for haematological malignancies in Europe between 1997 and 2008 by region and age: results of EUROCARE-5, a population-based study. Lancet Oncol. 2014;15(9):931–942. DOI: https://doi.org/10.1016/S1470-2045(14)70282-7 PMID:25030467
Darbà J, Marsà A. Burden of Hodgkin and non-Hodgkin lymphoma in Spain over a 10-year period: productivity losses due to premature mortality. Expert Rev Pharmacoecon Outcomes Res. 2021;21(1):87–92.DOI: https://doi.org/10.1080/14737167.2020.1769478 PMID:32450710
Cai W, Zeng Q, Zhang X, et al. Trends Analysis of Non-Hodgkin Lymphoma at the National, Regional, and Global Level, 1990–2019: Results From the Global Burden of Disease Study 2019. Front Med (Lausanne). 2021;8:738693. DOI: https://doi.org/10.3389/fmed.2021.738693 PMID:34631756
Miranda-Filho A, Piñeros M, Znaor A,et al. Global patterns and trends in the incidence of non-Hodgkin lymphoma. Cancer Causes Control. 2019;30(5):489–499. DOI: https://doi.org/10.1007/s10552-019-01155-5 PMID:30895415
Rotbain EC, Rostgaard K, Andersen MA, et al. Healthcare Utilization and Comorbidity in Chronic Lymphocytic Leukemia. Clin Epidemiol. 2021;13:1155–1165. DOI: https://doi.org/10.2147/CLEP.S337495 PMID:35002328
Pfeil AM, Imfeld P, Pettengell R, et al. Trends in incidence and medical resource utilisation in patients with chronic lymphocytic leukaemia: insights from the UK Clinical Practice Research Datalink (CPRD). Ann Hematol. 2015;94(3):421–429. DOI: https://doi.org/10.1007/s00277-014-2217-7 PMID:25219890
Lutz C, Feiten S, Chakupurakal G, et al. Patients with indolent lymphomas are at high risk of infections: experience from a German outpatient clinic. BMC Immunol. 2023;24(1):2. DOI: https://doi.org/10.1186/s12865-022-00536-x PMID:36631764
Johnson PC, Yi A, Horick N, et al. Clinical Outcomes, Treatment Toxicity, and Health Care Utilization in Older Adults with Aggressive Non-Hodgkin Lymphoma. Oncologist. 2021;26(11):965–973. DOI: https://doi.org/10.1002/onco.13915 PMID:34327767
Chanan-Khan A, Yang K, Liu S, et al. Real-World Disease Burden, Costs and Resource Utilization of Hospital-Based Care Among Mantle Cell Lymphoma, Waldenström Macroglobulinemia, Marginal Zone Lymphoma and Chronic Lymphocytic Leukemia: Disparities and Risk Factors. Blood. 2021;138(Supplement 1). DOI: 10.1182/blood-2021-148633
Kabadi SM, Goyal RK, Nagar SP, et al. Treatment patterns, adverse events, and economic burden in a privately insured population of patients with chronic lymphocytic leukemia in the United States. Cancer Med. 2019;8(8):3803–3810. DOI: https://doi.org/10.1002/cam4.2268 PMID:31144473
Rosand CB, Valla K, Flowers CR, et al. Effective management strategies for patients with marginal zone lymphoma. Future Oncol. 2018;14(12):1213–1222. DOI: https://doi.org/10.2217/fon-2017-0480 PMID:29260925
Sarosiek S, Treon SP, Castillo JJ. Reducing treatment toxicity in Waldenström macroglobulinemia. Expert Opin Drug Saf. 2021;20(6):669–676. DOI: https://doi.org/10.1080/14740338.2021.1897565 PMID:33645373
Additional Files
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2025 The authors
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Accepted 2025-02-05
Published 2025-03-11
