Costs of Venetoclax-Obinutuzumab vs. BTKi in CLL | Scott Huntington, MD, MPH, MSc | ASH 2023

So my name is Scott Huntington, associate professor of medicine at Yale, and I specialize in CLL and non-Hansken lymphoma. It's really exciting, ASH 2023, and I'd like to talk about one of our research works that we presented here today. CLL is a disease space where there's lots of great therapies, and most commonly we use targeted treatments. Historically, in the last decade or so, we've had a class of medications called Brutin, Tyrosine, and Kines inhibitors, which are taken usually daily until progression or intolerance, and most people will take these medications for years with great disease control and good quality of life. More recently, there's been development of another targeted oral class of therapy called the BCL2 inhibitor, the drugs called Venetoclax, in which case it leads to deeper remissions that allows patients often to stop treatment after about a year of therapy. We usually combine that drug with an IV medication called the Venetuzumab, and it allows patients to be on that combination therapy for a year, followed by a very long treatment-free interval. Now, many patients enjoy the ease of daily administration, but there may be other reasons and factors to use a fixed duration treatment, including economic benefit or a potential reduction in out-of-pocket costs for patients. What our analysis did is looked at the experience of patients receiving this treatment in the Medicare data. We had five years of data from Medicare claims, and we looked at patients newly starting CLL treatment in 2019. We classified patients as either taking the continuous Brutin, Tyrosine, and Kines inhibitors or receiving the fixed duration therapy of Venetuzumab and Venetoclax. And what we see is that first year when patients are on the continuous therapy and the fixed duration treatment, that the actual costs are very similar. But once a patient gets beyond that first year of therapy for the fixed duration, there's about a 60 to 70 percent reduction in the actual cost to Medicare. And that also can translate into reduced out-of-pocket expenses for patients. And so, at the end of the day, after a full year of treatment, when you look at patients that completed therapy, on average, it was about $8,000 per month less Medicare spending in patients that received the fixed duration of Venetuzumab and Venetoclax compared to the continuous therapy. Further data and really clinical data supports this treatment. And talking with your provider about what the best strategy is, both are phenomenal for patients, but there may be one versus the other that you can talk to your provider about either continuous therapy or fixed duration treatment. I appreciate your interest.