ASH 2023: Cost of Venetoclax + Obinutuzumab vs BTK Inhibitors for First-time Treated CLL Patients on Medicare

Dr. Scott Huntington from the Yale School of Medicine shared insight with HealthTree at the recent ASH 2023 conference about study findings that compared the cost between the fixed-duration treatment combination venetoclax (Venclexta) + obinutuzumab (Gazyva) to treatment with a continual-duration BTK inhibitor such as ibrutinib (Imbruvica), acalabrutinib (Calquence), or zanubrutinib (Brukinsa) for CLL patients on Medicare receiving treatment for the first time. Fixed duration means the treatment is administered over a set amount of time. Continual duration means the patient takes the medicine indefinitely until the CLL cells mutate and become resistant to treatment or the patient discontinues the medicine due to side effects.

The study found that costs for patients on venetoclax + obinutuzumab after the fixed-duration treatment period were approximately $8,000 per month lower than those taking the continual BTK inhibitor therapy. Watch Dr. Huntington’s interview below along with a written summary of the findings.

About the Study

Dr. Huntington and his colleagues reviewed data from 2016 to 2021 for CLL patients’ Medicare Parts A, B, and D claims. They focused on Medicare beneficiaries who started treatment with either venetoclax + obinutuzumab or a BTK inhibitor. The patients included in the analysis were at least 66 years old, had a diagnosis of CLL, had continuous medical and prescription coverage, had not received prior CLL treatment, and were monitored for costs after the completion of the fixed-duration venetoclax + obinutuzumab treatment. They evaluated healthcare cost measures including CLL-related monthly total, prescription, and medical costs over two periods: during treatment (months 0 to 12) and after treatment (months 13 to 18).

The study included 193 CLL patients in the venetoclax + obinutuzumab group and 1,577 CLL patients in the BTK inhibitor group. During the first 12 months, the monthly total costs were very similar for venetoclax + obinutuzumab patients compared to those on BTK inhibitors. The cost reduction became much more significant in the venetoclax + obinutuzumab group once patients got beyond their initial first year of treatment, showing a 67% reduction in the cost to Medicare compared to only a 10% reduction in the BTK inhibitor group. The larger cost reduction for the venetoclax + obinutuzumab group came mainly in the form of prescription drug costs. This indicates a significant economic benefit over continuous BTK inhibitor therapies which can translate into reduced out-of-pocket expenses for CLL patients. 

This real-world study demonstrates a substantial reduction in monthly healthcare costs among elderly Medicare beneficiaries with CLL following the fixed-duration treatment with venetoclax + obinutuzumab. The cost reduction was not seen in the BTK inhibitor group. As such, patients on venetoclax + obinutuzumab who completed therapy experienced an average monthly savings of $8,000 in Medicare spending compared to those on continuous BTK inhibitor therapy. Medical data supports the use of venetoclax + obinutuzumab as an effective CLL treatment, and now, Dr. Huntington's findings underscore the potential economic benefits of this treatment combination. Having a conversation with your doctor about the most suitable treatment plan for you, taking into account important financial considerations, is crucial to ensuring that your healthcare decisions align with both your medical needs and financial circumstances, ultimately promoting a well-informed and personalized approach to your CLL treatment journey.