Treatment options for patients with
previously-treated Chronic Lymphocytic Leukemia are limited; no standard of
care exists. In the Phase III RESONATE trial, oral, once-a-day, first-in-class
covalent Bruton’s tyrosine kinase inhibitor ibrutinib was associated with
improved Progression-Free Survival (PFS) (Hazard Ratio 0.106, 95% Confidence
Interval and Overall Survival compared with ofatumumab. The
current study evaluated the cost-effectiveness of ibrutinib compared to
commonly-used therapies for Relapsed or Refractory (R/R) CLL.
A health state model simulated a cohort of R/R
CLL patients receiving ibrutinib, ofatumumab, Idelalisib+Ofatumumab (IO), or
Physician’s Choice (PC) (a mixed bag of treatments) until death or disease
progression, at which point they received subsequent treatment or best
supportive care. PFS and OS were extrapolated based on data from RESONATE
(ibrutinib and ofatumumab) and from indirect treatment comparisons.
The analysis was conducted over a 30-year time
horizon from a Swedish healthcare payer perspective. Health outcomes and costs
were discounted per Swedish guidelines. Costs, Life Years (LYs),
Quality-Adjusted LYs (QALYs), and incremental costs per QALYs were evaluated.
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