Table 2. Model costs Costs . Baseline... | American Society of Hematology

Table 2.

Model costs

Costs	Baseline (US$)	Range (US$)	Study or reference
Bendamustine/treanda, 1 mg	28.88	—	J9033
Rituximab IV, 10 mg	94.97	—	J9312
Rituximab SQ, 10 mg	44.32	—	J9311
Ofatumumab, 10 mg	59.80	—	J9302
Pegfilgrastim, 6 mg	4 528.31	—	J2505
Ibrutinib, 420 mg, monthly	12 489.59	—	CMS plan finder tool
Venetoclax, 400 mg, monthly	11 482.76	—	CMS plan finder tool
Idelalisib, 300 mg, monthly	10 277.70	—	CMS plan finder tool
Routine office visit	112.80	105.32-152.91	CPT 99215
Chemotherapy IV infusion, first hour	143.08	124.35-188.20	CPT 96413
Chemotherapy IV infusion, additional hour	30.99	27.49-39.41	CPT 96415
Chemotherapy IV infusion, additional sequence	69.20	60.46-90.25	CPT 96417
Preinfusion medication	12.30	—	16
Chemotherapy SQ injection	80.73	70.32-105.51	CPT 96401
CBC with differential	8.63	—	CPT 85025
Comprehensive metabolic panel	11.74	—	CPT 80053
Best supportive care, monthly	196.50	189.02-236.61	16
End-of-life care	83 053.18	56 467.50-214 892.37	37,38,39

Costs	Baseline (US$)	Range (US$)	Study or reference
Bendamustine/treanda, 1 mg	28.88	—	J9033
Rituximab IV, 10 mg	94.97	—	J9312
Rituximab SQ, 10 mg	44.32	—	J9311
Ofatumumab, 10 mg	59.80	—	J9302
Pegfilgrastim, 6 mg	4 528.31	—	J2505
Ibrutinib, 420 mg, monthly	12 489.59	—	CMS plan finder tool
Venetoclax, 400 mg, monthly	11 482.76	—	CMS plan finder tool
Idelalisib, 300 mg, monthly	10 277.70	—	CMS plan finder tool
Routine office visit	112.80	105.32-152.91	CPT 99215
Chemotherapy IV infusion, first hour	143.08	124.35-188.20	CPT 96413
Chemotherapy IV infusion, additional hour	30.99	27.49-39.41	CPT 96415
Chemotherapy IV infusion, additional sequence	69.20	60.46-90.25	CPT 96417
Preinfusion medication	12.30	—	16
Chemotherapy SQ injection	80.73	70.32-105.51	CPT 96401
CBC with differential	8.63	—	CPT 85025
Comprehensive metabolic panel	11.74	—	CPT 80053
Best supportive care, monthly	196.50	189.02-236.61	16
End-of-life care	83 053.18	56 467.50-214 892.37	37,38,39

—, not applicable.