In comparison with first-line chemoimmunotherapy, ibrutinib is associated with significant cost savings among Medicare beneficiaries with chronic lymphocytic leukemia (CLL) of small lymphocytic lymphoma (SLL; Curr Med Res Opin. 2020;1-10. doi:10.1080/03007995.2020.1835851).
This study identified adult patients with CLL or SLL receiving first-line ibrutinib or chemoimmunotherapy between March 4, 2016, and September 30, 2017, using fee-for-service and Medicare Advantage claims data. The aim of the study was to compare healthcare resource utilization (HRU) and costs of these therapies in this patient population.
HRU and costs were evaluated during first line Oncology Care Model (OCM) episodes (6 months post-index) and over the observed first line duration. Mean monthly cost differences (MMCD) obtained from ordinary least square regressions were used to compare costs between ibrutinib and chemoimmunotherapy cohorts.
The Medicare fee-for-service data set included 4064 patients treated with either ibrutinib (n = 2014) or chemoimmunotherapy (n = 2050).
Overall, patients treated with ibrutinib experienced significantly higher monthly pharmacy costs (MMCD = $4878 for OCM episodes; MMCD = $4892 over the duration of treatment). However, these costs were fully offset by lower monthly medical costs (MMCD = -$8289 for OCM episodes; MMCD = $-5888 over the duration of treatment).
The total health care cost reduction of first-line ibruntib was -$3411 for OCM episodes and -$996 for the duration of treatment in comparison with chemoimmunotherapy.
The Medicare Advantage dataset included 596 patients treated with ibrutinib (n = 293) or chemoimmunotherapy (n = 303). Again, ibrutinib was associated with a total monthly health care cost reduction of -$10,459 for OCM episodes and -$5492 for the duration of treatment in comparison with chemoimmunotherapy.
“In Medicare patients with CLL/SLL, [first-line] ibrutinib single agent was associated with total monthly cost savings relative to [first-line chemoimmunotherapy], driven by lower monthly medical costs that fully offset higher monthly pharmacy costs,” researchers concluded.—Janelle Bradley
