CLL: frontline ibrutinib monotherapy less expensive than chemoimmunotherapy

  • Emond B & al.
  • Clin Lymphoma Myeloma Leuk
  • 26 Aug 2019

  • curated by David Reilly
  • Univadis Clinical Summaries
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Takeaway

  • For patients with chronic lymphocytic leukemia (CLL), frontline ibrutinib monotherapy is associated with lower total costs vs chemoimmunotherapy (CIT) and less health care resource utilization.

Why this matters

  • Ibrutinib is FDA-approved for the frontline treatment of CLL, regardless of TP53 mutation status.

Study design

  • Study to compare costs with frontline ibrutinib monotherapy (n=322) vs CIT (n=839) in the treatment of CLL.
  • Data source: Optum Clinformatics Extended DataMart De-Identified Databases.
  • Funding: Janssen Scientific Affairs, LLC.

Key results

  • Lower likelihood of next therapy with ibrutinib vs CIT (HR, 0.54; 95% CI, 0.33-0.90; P=.0163).
  • Fewer monthly days with outpatient visits with ibrutinib vs CIT (rate ratio, 0.75; 95% CI, 0.60-0.94; P=.0200).
  • Frontline therapy (overall):
    • $3766 (95% CI, −$5015 to −$1947; P<.0001 lower monthly all-cause total costs with ibrutinib vs cit.>
    • $6849 (95% CI, $6245-$7593; P<.0001 higher pharmacy costs per-patient-per-month vs cit.>
    • $10,615 (95% CI, −$12,022 to −$8917; P<.0001 lower mean monthly medical costs vs cit.>
  • Frontline therapy (first 6 months):
    • $8365 (95% CI, −$9975 to −$6464; P<.0001 lower monthly all-cause total costs with ibrutinib vs cit savings also driven by mean medical cit.>
  • Limitations

    • Retrospective data.