Heidi D. Finnes

Impact of Ibrutinib and Idelalisib on the Pharmaceutical Cost of Treating Chronic Lymphocytic Leukemia at the Individual and Societal Levels

PURPOSE To evaluate the impact of approval of ibrutinib and idelalisib on pharmaceutical costs in the treatment of chronic lymphocytic leukemia (CLL) at the societal level and assess individual out-of-pocket costs under Medicare Part D. METHODS Average wholesale price of commonly used CLL treatment regimens was ascertained from national registries. Using the population of Olmsted County, Minnesota, we identified the proportion of patients with newly diagnosed CLL who experience progression to the point of requiring treatment. Using these data, total pharmaceutical cost over a 10-year period after diagnosis was estimated for a hypothetic cohort of 100 newly diagnosed patients under three scenarios: before approval of ibrutinib and idelalisib (historical scenario), after approval of ibrutinib and idelalisib as salvage therapy (current scenarios A and B), and assuming use of ibrutinib as first-line treatment (potential future scenario). RESULTS Estimated 10-year pharmaceutical costs for 100 newly diagnosed patients were as follows:

Neurological Complications Associated With Anti–Programmed Death 1 (PD-1) Antibodies

4,565,929 (approximately

Ipilimumab-induced colitis in patients with metastatic melanoma.

45,659 per newly diagnosed patient and

Pharmacovigilance during ibrutinib therapy for chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) in routine clinical practice.

157,446 per treated patient) for the historical scenario,

Therapeutic options for patients with lymphoma and liver dysfunction or failure during mechlorethamine shortage.

7,794,843 (approximately

Drug–drug interaction between bosutinib and warfarin

77,948 per newly diagnosed patient and

Combining Immune Checkpoint Inhibitors With Conventional Cancer Therapy

268,788 per treated patient) for current scenario A,

Brief Report: Cancer Immunotherapy in Patients With Preexisting Rheumatic Disease: The Mayo Clinic Experience

6,309,162 (approximately

Efficacy, safety, and dose adjustment of cyclophosphamide in lymphoma patients requiring hemodialysis

63,092 per newly diagnosed patient and

Chemotherapy in the Setting of Severe Liver Dysfunction in Patients with Metastatic Colorectal Cancer

217,557 per treated patient) for current scenario B, and