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学术及社区医疗环境中的多发性骨髓瘤护理、治疗模式及治疗持续时间。

Multiple myeloma care, treatment patterns, and treatment durations in academic and community care settings.

作者信息

Boytsov Natalie, McGuiness Catherine B, Zhou Zifan, Huo Tianyao, Montgomery Kathleen, Kotowsky Nirali, Chen Chi-Chang

机构信息

Real World Evidence & Health Outcomes Research, GSK, Upper Providence, PA, USA.

Health Economics and Outcomes Research, IQVIA, King of Prussia, PA, USA.

出版信息

Future Oncol. 2025 Jun;21(15):1905-1918. doi: 10.1080/14796694.2025.2504318. Epub 2025 May 21.

Abstract

AIM

Evaluate multiple myeloma (MM) treatment patterns, healthcare utilization (HCRU), and costs from academic and community settings.

METHODS

This observational study linked US MM insurance claims (1 April 2017-30 June 2022) with provider affiliations to evaluate patient characteristics and treatment durations across patient cohorts defined by care setting of treatment (academic only, community only, mixed [both]), as well as treatment patterns, HCRU, and costs of care (e.g. treatment, office visits, hospitalization) in each setting.

RESULTS

3778 patients were included. By cohort ( = 530 academic;  = 1647 community), the community cohort was older with more comorbidities. Mixed-cohort patients ( = 1601) frequently initiated treatment at community centers and briefly shifted to academic centers for transplant. Among 3778 patients who received MM-related care, most claims were from the community setting. The academic setting had high rates of claims for proteasome inhibitors (56.3% of patients) and steroids (52.5%); the community setting had high rates for immunomodulatory drugs (75.1%) and steroids (85.0%). Stem cell transplant claims were more common for academic versus community (21.4%/7.3%). Treatment duration/time to next therapy were similar between cohorts. Costs were generally higher in the academic versus community settings.

CONCLUSION

Improved patient support is needed in community settings, where most MM care occurs.

摘要

目的

评估学术机构和社区机构中多发性骨髓瘤(MM)的治疗模式、医疗资源利用(HCRU)及成本。

方法

这项观察性研究将美国MM保险理赔数据(2017年4月1日至2022年6月30日)与医疗机构附属关系相联系,以评估不同治疗机构(仅学术机构、仅社区机构、混合机构[两者皆有])定义的患者队列的患者特征和治疗时长,以及各机构的治疗模式、HCRU和医疗成本(如治疗、门诊就诊、住院)。

结果

共纳入3778例患者。按队列划分(学术机构队列=n=530;社区机构队列=n=1647),社区机构队列患者年龄更大,合并症更多。混合队列患者(n=1601)常于社区中心开始治疗,后短期转至学术中心进行移植。在接受MM相关治疗的3778例患者中,大多数理赔来自社区机构。学术机构中蛋白酶体抑制剂(56.3%的患者)和类固醇(52.5%)的理赔率较高;社区机构中免疫调节药物(75.1%)和类固醇(85.0%)的理赔率较高。与社区机构相比,学术机构的干细胞移植理赔更为常见(21.4%/7.3%)。各队列间的治疗时长/至下一治疗的时间相似。学术机构的成本总体高于社区机构。

结论

在大多数MM治疗发生的社区机构,需要改善患者支持。

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