Follicular lymphoma or diffuse large B-cell lymphoma: a population based analysis of epidemiological and health economic aspects in Germany

Contemporary information on epidemiology, healthcare resource utilization (HCRU), costs and clinical outcomes in routine care is essential for value-based decision-making. However, such information remains limited for follicular lymphoma (FL) and diffuse large B-cell lymphoma (DLBCL) in Germany. This study addresses these gaps. This retrospective cross-sectional cost-of-illness study analyzed anonymized statutory health insurance claims data (2015-2020). FL Grade I-IIIa (ICD-10: C82.0-C82.3), DLBCL (ICD-10: C83.3) patients were identified via inpatient or outpatient ICD coding. Elixhauser and Charlson Comorbidity Indices were used to describe the general comorbidity burden. FL prevalence increased from 26 to 32 per 100,000 insured persons (n = 837 to 1,028), DLBCL prevalence rose from 37 to 45 per 100,000 (n = 1,205 to 1,437). Mean age (FL: 67.0 ± 13; DLBCL: 68.6 ± 13.6) and sex distribution (FL: 50% female; DLBCL: 44% female) remained stable 2015-2020. Mean Charlson Comorbidity Index 4.1 ± 2.4 (FL), 4.8 ± 2.7 (DLBCL), mean Elixhauser 5.2 ± 3.0 (FL), 6.1 ± 3.3 (DLBCL). Hospitalization rates: 64% of FL patients (2.0 ± 2.3 admissions, 21 ± 44.7 days/year); 78% of DLBCL patients (2.9 ± 3.1 admissions, 29 ± 47.5 days/year). Mean annual costs per patient in third-party payers perspective were €15,258 (FL), €23,455 (DLBCL). Post-SCT 12-month costs were €46,270 (FL), €56,558 (DLBCL) for autologous-SCT, and €161,662 for allogeneic-SCT (DLBCL only). Rising prevalence calls for ongoing real-world assessment of HCRU and costs. This study supplements limited evidence, highlighting significant economic impact. While health insurance data offer valuable insights, their lack of clinical details necessitates integration with other data sources. Several initiatives are building data spaces to enhance evidence generation; meanwhile, analyses based on single data sources remain valuable to inform practice and policy.