{"id":6503,"date":"2025-06-23T18:32:28","date_gmt":"2025-06-23T18:32:28","guid":{"rendered":"https:\/\/medical-article.com\/?p=6503"},"modified":"2025-06-23T18:32:28","modified_gmt":"2025-06-23T18:32:28","slug":"cost-impact-of-btki-selection-in-medicare-patients-with-cll","status":"publish","type":"post","link":"https:\/\/medical-article.com\/?p=6503","title":{"rendered":"Cost impact of BTKi selection in Medicare patients with CLL"},"content":{"rendered":"<p>That is the title of my <a href=\"https:\/\/becarispublishing.com\/doi\/10.57264\/cer-2025-0035\">paper out today in the <\/a><em><a href=\"https:\/\/becarispublishing.com\/doi\/10.57264\/cer-2025-0035\">Journal of Comparative Effectiveness Research<\/a><\/em> written with co-authors Adam Kittai, Dipen Patel, Nadine Zawadzki, Vikram Shetty, Yazan Barqawi, and Joanna Rhodes.  The abstract is below.<\/p>\n<p><strong>Aim:<\/strong>\u00a0To estimate cost savings associated with covalent Bruton\u2019s tyrosine kinase inhibitor (cBTKi) choice in patients with treatment-naive (TN) and relapsed\/refractory (RR) chronic lymphocytic leukemia (CLL) from a Medicare perspective.\u00a0<\/p>\n<p><strong>Materials<\/strong>\u00a0<strong>&amp;<\/strong>\u00a0<strong>methods:<\/strong>\u00a0An economic model with Markov structure simulated outcomes in patients with CLL initiating ibrutinib, acalabrutinib or zanubrutinib monotherapy. Modeled population included TN and RR patients who had no prior cBTKi. Treatments were dosed per US FDA label and efficacy assumed identical across cBTKis. Cumulative grade \u22653 adverse event (AE) rates were drawn from extended follow-up of cBTKi phase III clinical trials at similar duration. Costs included drug price per 2024 wholesale acquisition cost and AE management medical costs from literature, adjusted for Medicare reimbursement. Outcomes were total change in payer cost over 1, 3 and 5\u00a0years.\u00a0<\/p>\n<p><strong>Results:<\/strong> A cohort of 13,726 patients with CLL was modeled (44% TN, 56% RR). Acalabrutinib\u2019s aggregate grade \u22653 AE rate was 25.8% points less in TN patients (35.8% vs 61.6%) and 8.0% points less in RR patients (75.0% vs 83.0%) compared with ibrutinib, and 20.6% points less in TN patients (35.8% vs 56.4%) and 11.1% points less in RR patients (75.0% vs 86.1%) compared with zanubrutinib. Acalabrutinib saved $15,478 more per patient versus ibrutinib in year 1 due to lower treatment cost (-$12,076) and lower AE cost (-$3402). Acalabrutinib also saved $1901 more per patient versus zanubrutinib as acalabrutinib higher treatment cost (+$1663) was offset by lower AE cost (-$3563). Across all patients, acalabrutinib saved $212 million more versus ibrutinib and $26 million more versus zanubrutinib from a Medicare perspective. Acalabrutinib cost savings persisted over 3 and 5 years. <\/p>\n<p><strong>Conclusion:<\/strong>\u00a0Acalabrutinib yielded cost savings versus ibrutinib and zanubrutinib for patients with CLL in Medicare due to lower treatment cost versus ibrutinib and fewer grade \u22653 AEs versus both ibrutinib and zanubrutinib. <\/p>\n<p>You can read the full paper <strong><a href=\"https:\/\/becarispublishing.com\/doi\/10.57264\/cer-2025-0035\">here<\/a><\/strong>.<\/p>","protected":false},"excerpt":{"rendered":"<p>That is the title of my paper out today in the Journal of Comparative Effectiveness Research written with co-authors Adam Kittai, Dipen Patel, Nadine Zawadzki, Vikram Shetty, Yazan Barqawi, and Joanna Rhodes. The abstract is below. Aim:\u00a0To estimate cost savings associated with covalent Bruton\u2019s tyrosine kinase inhibitor (cBTKi) choice in patients with treatment-naive (TN) and&#8230;<\/p>\n","protected":false},"author":0,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-6503","post","type-post","status-publish","format-standard","hentry","category-articles"],"_links":{"self":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/6503"}],"collection":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=6503"}],"version-history":[{"count":0,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/6503\/revisions"}],"wp:attachment":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=6503"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=6503"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=6503"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}