Presentation (CTI)

OBJECTIVES: Compare the cost of progression free survival (PFS) and time to next treatment (TTNT) of ibrutinib plus venetoclax (I+V) and acalabrutinib plus venetoclax (A+V) for the treatment of patients with untreated chronic lymphocytic leukemia (CLL) in the Brazilian private healthcare system.
METHODS: The therapies considered in this analysis were every all-oral, fixed-duration targeted therapies with local regulatory approval for the treatment of untreated CLL at the time of development of this analysis (I+V and A+V). The PFS and TTNT data of I+V were retrieved from the 66 months follow up of the CAPTIVATE trial. The PFS and TTNT Kaplan-Meier curves of A+V were retrieved from the clinical trial AMPLIFY, and they were extrapolated as to estimate the PFS and TTNT value for the 66^th month mark of A+V in order to compare with the most recent data from CAPTIVATE. Only drug acquisition costs were considered in the calculation of the treatment cost, which were calculated following regulatory approved drug label dosage. Drug costs were retrieved from the Brazilian official drug price list (2026). The cost of PFS and TTNT were calculated by dividing the total treatment cost of each regimen by its corresponding PFS and TTNT value (in %), at the 66^th month mark.
RESULTS: The PFS and TTNT for the 66^th month mark of I+V were 66,00% and 73,00%. As for A+V, the projected values for PFS and TTNT were 39,05% and 51,30%, respectively. I+V showed lower cost per PFS and cost per TTNT vs A+V (R$1,63 million [M] vs R$2,05M, R$1,47M vs R$1,56M respectively).
CONCLUSIONS: Considering its drug cost profile, PFS and TTNT values, alongside the projected PFS and TTNT values for the comparator, I+V could represent an optimal all-oral, fixed-duration targeted therapy choice for the treatment of patients with untreated chronic lymphocytic leukemia (CLL) in the Brazilian private healthcare system.