A recent real-world study compared health care resource utilization (HCRU) and costs associated with first-line ibrutinib monotherapy vs bendamustine plus rituximab for patients with chronic lymphocytic leukemia (CLL; Curr Med Res Opin. 2021;37[4]:623-628. doi:10.1080/03007995.2021.1884540.)
The IBM MarketScan Research Databases were used to identify patients with CLL based on the first prescription of either ibrutinib or bendamustine plus rituximab between February 1, 2014 and August 30, 2017.
A total of 1866 treatment-naïve patients with CLL were identified; 1157 who received ibrutinib and 729 who received bendamustine plus rituximab.
At least one inpatient admission was reported for 34% of patients receiving ibrutinib vs 24% of patients receiving bendamustine plus rituximab. In addition, at least one CLL-related inpatient admission was reported for 31% vs 20% of patients in each group, respectively.
Overall, patients who received ibrutinib monotherapy had more frequent emergency room visits than those who received bendamustine plus rituximab.
No difference in total cost, including both all-cause and CLL-related costs, was reported between the two groups. However, patients receiving ibrutinib had significantly higher inpatient costs as well as outpatient pharmacy prescription costs than those receiving bendamustine plus rituximab. Per person per month outpatient medical costs were significantly higher for patients receiving bendamustine plus rituximab.
Due to higher rates of inpatient admissions, longer lengths of stays, and more ER visits for ibrutinib vs bendamustine plus rituximab, Debra Irwin, IBM Watson Health, Cambridge, MA, and colleagues suggest that more real-world effectiveness research needs to be conducted.
“Given the differences in costs, it is important to further examine the impact these healthcare expenditures have on the cost-effectiveness of [ibrutinib monotherapy] first line treatment,” concluded Dr Irwin and colleagues.—Marta Rybczynski
