OBJECTIVES:   The objective of this pharmacoeconomic evaluation was to assess the life-time incremental costs and health benefits of ibrutinib compared to all relevant treatments in Dutch clinical practice for adult patients with relapsed chronic lymphocytic leukaemia (CLL), from a societal perspective.  METHODS:   A partitioned survival model (3-month cycle length) was used to estimate and extrapolate treatment response, progression-free survival and overall survival for relapsed CLL patients receiving either ibrutinib or: ofatumumab, bendamustine+rituximab, bendamustine, fludarabine+cyclophosphamide+rituximab, rituximab monotherapy, rituximab+chlorambucil or chlorambucil monotherapy. Relative treatment efficacy was determined by direct (extrapolated) trial results for ibrutinib and ofatumumab (based on the RESONATE trial) and indirect treatment comparisons for the remaining comparators. Differences in treatment efficacy were translated to different probabilities of being in one of the model health states: “progression-free survival”, “post progression survival” or “death”. Patients’ baseline characteristics were derived from the Netherlands cancer registry (hemato-oncology/PHAROS). Dutch-specific costs for drugs, monitoring, resource use and adverse events, and health outcomes were calculated to estimate the incremental cost-effectiveness ratio (ICER). Uncertainties around cost and health outcomes were tested using deterministic-, probabilistic- and scenario analyses. RESULTS:   Ibrutinib showed life-time incremental health gains up to 3.99 QALYs and 5.46 life-years (LYs). The ICER was €54,264 per QALY gained versus ofatumumab and ranged between €54,833 and €67,754 versus the indirect comparators. ICERs per LY gained ranged from €40,051 to €51,196. Sensitivity analyses showed that relative treatment efficacy was the most influential model parameter. The cost-effectiveness acceptability curve indicated ibrutinib was most cost-effective as from a willingness-to-pay threshold of €78,000 per QALY gained. CONCLUSIONS:   Ibrutinib has been shown in clinical trials to be an effective treatment for relapsed CLL patients. Based on this model and taking into consideration the high disease burden, these results suggest that ibrutinib is likely to be cost-effective for treatment of Dutch relapsed CLL patients.