Introducing 12-month fixed duration venetoclax plus obinutuzumab as first-line treatment for chronic lymphocytic leukemia (CLL) resulted in significant cost-savings compared with chemoimmunotherapies and ibrutinib-based therapies (Pharmacoeconomics. 2020;38[9]:941-951. doi:10.1007/s40273-020-00919-1).
“This study aimed to assess the total cost of care (TCC) and budget impact of introducing 12-month fixed duration venetoclax plus obinutuzumab as first-line treatment for [CLL] from the perspective of a US health plan with 1,000,000 (1M) members,” wrote the study authors.
In the study, fludarabine plus cyclophosphamide and rituximab (FCR), bendamustine plus rituximab (BR), obinutuzumab plus chlorambucil, ibrutinib, and ibrutinib plus rituximab/obinutuzumab were compared in a 3-year model. Costs associated with treatment, adverse events, routine care, and monitoring were included in the TCC. The budget impact outcomes of the treatment were described as per-member-per-month (PMPM) costs.
Introducing venetoclax plus obinutuzumab resulted in a cost savings of PMPM $0.04 over the 3-year horizon. The fixed 12-month duration of venetoclax plus obinutuzumab reduced the cumulative treatment costs compared to ibrutinib-based therapies.
The annual TCC per patient for venetoclax plus obinutuzumab in 1 year was similar to other targeted therapies but after year 2, the costs decreased, while ibrutinib, ibrutinib plus rituximab, and ibrutinib plus obinutuzumab remained similar to the first year. Thus, the costs over 3 years for venetoclax plus obinutuzumab resulted in a maximum savings of $367,001.
“Economic benefits of [venetoclax plus obinutuzumab], a novel agent with fixed treatment duration, coupled with proven clinical benefits should help inform formulary adoption decisions and treatment recommendations,” concluded the study authors.—Lisa Kuhns
