OBJECTIVES: Chronic lymphocytic leukemia (CLL) is an incurable disease affecting approx. 1 per 100,000 persons in mainland China. Ibrutinib has been recently compared with Rituximab in a clinical trial (Clinicaltrials.gov ID: NCT01973387) among the Chinese population with relapsed or refractory CLL. Ibrutinib has also been approved in China, but to the best of our knowledge, no economics evaluation of this treatment in the Chinese population has been carried out yet. Therefore, the objective of this study was to conduct the cost-effectiveness of Ibrutinib and Rituximab for the adult Chinese population with relapsed or refractory CLL.

METHODS: We constructed a decision tree analysis for a short-term time horizon (1 year), involving 3 health states: disease progression free, progressive disease, and death. A Chinese payer perspective was used for this analysis. Medication prices were obtained from the Chinese government system of centralized bidding procurement. All costs were inflated to the 2017 Chinese Yuan value. All other inputs and the probabilities for decision tree were calculated from the randomized controlled trial comparing Ibrutinib and Rituximab among the adult patients with relapsed or refractory CLL. The analysis was performed using TreeAge Pro 2017.

RESULTS: One-year expenditure for Ibrutinib was 700,766 Chinese Yuan, compared to 95,611 Chinese Yuan of Rituximab. Incremental cost of Ibrutinib to reduce one event of death for one year was found to be 480,715 Chinese Yuan in this analysis.

CONCLUSIONS: Based on the results of this analysis, the cost to prevent one death event for one year by Ibrutinib might be debatable.