OBJECTIVES: Obinutuzumab is the first, glycoengineered type II antibody demonstrating increased Antibody-Dependent Cell-Mediated Cytotoxicity (ADCC) and direct cell death compared with rituximab (Rtx) and is pending regulatory approval (in combination with chlorambucil (Clb)) for the treatment of patients with previously untreated chronic lymphocytic leukemia (CLL). Obinutuzumab+Clb has shown >85% reduction in the risk of progression, relapse or death in comparison to treatment with Clb alone (HR 0.14), a broadly accepted treatment option for many patients with co-existing medical conditions. In a majority of markets the health economic consequences will be assessed in terms of affordability. METHODS: A health economic model was developed analyzing the cost impact of obinutuzumab on further lines of treatment due to the number of reduced refractory patients compared to Clb and Rtx. Market share information for obinutuzumab, ofatumumab, Rtx, Clb and Bendamustine and the different relevant combinations were entered for Germany and Canada (Ontario province only). RESULTS: Based on a 39% reduction in numbers of refractory patients treated with obinutuzumab+Clb compared to Rtx+Clb cost savings per year per patient (PYPP) for further line treatments in Canada (Ontario) range between Ca$950 and Ca$3,091, which leads to maximum cost savings for the whole eligible population (401 patients) up to $Ca1,239,491. In Germany the cost savings range PYPP between €2,556 and €8,318, which leads to maximum cost savings for the whole eligible population (1,302 patients) up to €10,830,036. The big difference in the cost savings PYPP between the two countries is mainly due to the different market share assumptions for ofatumumab. Key cost drivers were treatment duration and price/cost of further line treatments. Scenario analyses on cost, efficacy and market share data confirmed these findings. CONCLUSIONS: Obinutuzumab+Clb shows significant patient-relevant clinical benefits and potential cost savings in further line treatments in patients with previously untreated CLL.