COST-SAVINGS ASSOCIATED WITH VENETOCLAX-OBINUTUZUMAB VERSUS COVALENT BRUTON’S TYROSINE KINASE INHIBITOR IN FRONTLINE CHRONIC LYMPHOCYTIC LEUKEMIA: A REAL-WORLD STUDY
Author(s)
Alan P. Skarbnik, MD1, Nnadozie Emechebe, MPH, PhD2, Bita Fakhri, MD, MPH3, Samin Houshyar, MD4, Beenish S. Manzoor, MPH, PhD2, Nilanjan Ghosh, MD, PhD5, Mazyar Shadman, MD6, Godwin Okoye, PhD2, Sophia S. Li, MPH7, Paul M. Barr, MD4;
1Lymphoma and CLL Program, Novant Health Cancer Institute, Charlotte, NC, USA, 2AbbVie, Inc., North Chicago, IL, USA, 3Stanford Cancer Institute, Stanford University, Stanford, CA, USA, 4Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA, 5Levine Cancer Institute/Atrium Health, Charlotte, NC, USA, 6Fred Hutchinson Cancer Research Center, Seattle, WA, USA, 7Genentech Inc., South San Francisco, CA, USA
1Lymphoma and CLL Program, Novant Health Cancer Institute, Charlotte, NC, USA, 2AbbVie, Inc., North Chicago, IL, USA, 3Stanford Cancer Institute, Stanford University, Stanford, CA, USA, 4Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA, 5Levine Cancer Institute/Atrium Health, Charlotte, NC, USA, 6Fred Hutchinson Cancer Research Center, Seattle, WA, USA, 7Genentech Inc., South San Francisco, CA, USA
OBJECTIVES: To examine healthcare costs prior and post-completion of the fixed-duration treatment (FDT) period for venetoclax plus obinutuzumab (VenO) relative to continuous treat-to-progression therapies, like covalent Bruton’s tyrosine kinase inhibitors (cBTKis) for frontline (1L) chronic lymphocytic leukemia (CLL).
METHODS: This retrospective cohort study utilized the Optum Clinformatics DataMart from 01/2010-03/2025 and included adult patients with CLL who received 1L VenO or cBTKi-based regimens between 12/2019-03/2023 and had continuous enrollment ≥24 months after 1L initiation. Cohorts were balanced using stabilized inverse probability of treatment weights. Healthcare cost measures included all-cause and CLL-related per-patient-per-month (PPPM) total, prescription, and medical costs. PPPM costs were captured during Months 1-12 (on-treatment period for VenO) and Months 13-24 (off-treatment period for VenO) after 1L initiation. PPPM all-cause and CLL-related costs were compared between cohorts using a weighted generalized estimating equation model.
RESULTS: The final sample included 915 patients (VenO: 154; cBTKi: 761). Between Months 1-12, mean all-cause total costs PPPM were slightly lower for VenO ($16,140) than cBTKi patients ($16,971). During Months 13-24, all-cause total costs PPPM declined by 69% for VenO patients ($16,140 to $5,021) and 23% for cBTKi patients ($16,971 to $13,099). The weighted estimated cost savings PPPM during the off-treatment period for VenO vs cBTKi treated patients was $6,430 (95% CI: $7,843-$5,018; p<0.0001). Results were similar for CLL-related costs, with substantially larger reductions in CLL-related total PPPM costs for VenO versus cBTKis primarily driven by greater reductions in CLL-related prescription drug costs.
CONCLUSIONS: This real-world study of patients with CLL demonstrates a substantial reduction in monthly healthcare costs in the VenO group after the 12-month FDT period, largely driven by reduced CLL-related prescription drug costs. These findings, consistent with previous studies, support the economic benefits of VenO, which offers patients a treatment-free period, relative to treat-to-progression therapies like cBTKis.
METHODS: This retrospective cohort study utilized the Optum Clinformatics DataMart from 01/2010-03/2025 and included adult patients with CLL who received 1L VenO or cBTKi-based regimens between 12/2019-03/2023 and had continuous enrollment ≥24 months after 1L initiation. Cohorts were balanced using stabilized inverse probability of treatment weights. Healthcare cost measures included all-cause and CLL-related per-patient-per-month (PPPM) total, prescription, and medical costs. PPPM costs were captured during Months 1-12 (on-treatment period for VenO) and Months 13-24 (off-treatment period for VenO) after 1L initiation. PPPM all-cause and CLL-related costs were compared between cohorts using a weighted generalized estimating equation model.
RESULTS: The final sample included 915 patients (VenO: 154; cBTKi: 761). Between Months 1-12, mean all-cause total costs PPPM were slightly lower for VenO ($16,140) than cBTKi patients ($16,971). During Months 13-24, all-cause total costs PPPM declined by 69% for VenO patients ($16,140 to $5,021) and 23% for cBTKi patients ($16,971 to $13,099). The weighted estimated cost savings PPPM during the off-treatment period for VenO vs cBTKi treated patients was $6,430 (95% CI: $7,843-$5,018; p<0.0001). Results were similar for CLL-related costs, with substantially larger reductions in CLL-related total PPPM costs for VenO versus cBTKis primarily driven by greater reductions in CLL-related prescription drug costs.
CONCLUSIONS: This real-world study of patients with CLL demonstrates a substantial reduction in monthly healthcare costs in the VenO group after the 12-month FDT period, largely driven by reduced CLL-related prescription drug costs. These findings, consistent with previous studies, support the economic benefits of VenO, which offers patients a treatment-free period, relative to treat-to-progression therapies like cBTKis.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE251
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Oncology