Cost–effectiveness of BTK inhibitors vs bendamustine and rituximab in chronic lymphocytic leukemia patients

Abstract

Background: We aimed to compare the cost–effectiveness of bruton tyrosine kinase inhibors (BTKis) versus bendamustine–rituximab (R-bendamustine) as a first-line treatment for Chinese patients with relapsed or refractory chronic lymphocytic leukemia. Methods: A partitioned survival model was constructed using TreeAge Pro 2022 software and transition probabilities were estimated from the reported survival probabilities using parametric survival modeling. One-way analysis and probabilistic sensitivity analysis were performed to explore the uncertainty of the modeling results. In addition, several scenario analyses were evaluated. Results: In comparison to R-bendamustine, zanubrutinib had an incremental cost–effectiveness ratio (ICER; life years) and ICER (quality-adjusted life years) of US$12,173.38 and $17,983.40, respectively. While ibrutinib had a higher ICER relative to R-bendamustine. Conclusion: Zanubrutinib was cost-effective for patients with relapsed or refractory chronic lymphocytic leukemia in China.

Tweetable abstract: We studied the cost–effectiveness of BTK inhibitors versus bendamustine and rituximab in relapsed or refractory chronic lymphocytic leukemia patients, finding that zanubrutinib was cost effective compared with ibrutinib and bendamustine and rituximab.

Keywords::

• bendamustine-rituximab
• bruton tyrosine kinase
• chronic lymphocytic leukemia
• cost–effectiveness
• ibrutinib
• zanubrutinib

Supplementary data

To view the supplementary data that accompany this paper please visit the journal website at: www.tandfonline.com/doi/suppl/10.2217/fon-2023-0574

Author contributions

Conceptualization: J Wu; acquisition of data and writing: J Nie; writing – original draft preparation: H Wu; writing – review and editing: Q Wu and Q Liu; supervision: L Liu. All authors have read and agreed to the published version of the manuscript.

Financial disclosure

This work was supported by grants ZR2022LSW023 from Shandong Provincial Natural Science Foundation. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Competing interests disclosure

The authors have no competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, stock ownership or options and expert testimony.

Writing disclosure

The authors thank KetengEdit (www.Ketengedit.com) for English language editing service during the preparation of the manuscript. In addition, the funding source for this language editing is from Shandong Provincial Natural Science Foundation (ZR2022LSW023).

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.