OBJECTIVES: There are several treatment protocols available for chronic lymphocytic leukemia (CLL). Each of these protocols is associated with possible additional costs, such as hospitalization and monitoring costs. This study aims to evaluate the financial consequences of introducing Venetoclax plus Obinutuzumab (VEN+G) for a one-year fixed treatment duration for treating first-line CLL on the public payer’s budget in Saudi Arabia.

METHODS: A three-state partitioned-survival model was used to simulate patients’ progression-free survival and overall survival, accounting to the disease’s incidence and prevalence over 5 years. We compared a scenario of a world with VEN+G versus world without VEN+G incorporating other treatment options’ market shares based on local inputs. Ten comparator protocols were included: Chlorambucil+ Obinutuzumab, Fludarabine+ Cyclophosphamide+ Rituximab, Bendamustine+ Rituximab, Chlorambucil+ Rituximab, Ibrutinib, Generic Ibrutinib, Ibrutinib+ Rituximab, Chlorambucil, Acalabrutinib, and Acalabrutinib+ Obinutuzumab. A deterministic sensitivity analysis (DSA) was conducted to test the robustness of the results.

RESULTS: Introducing VEN+G into the Saudi healthcare system for first line CLL resulted in a neutral budget impact over 5 years (minimal budget savings of 223 thousand Saudi Riyals (SAR)). 5-year Cumulative costs decreased from 301.5 million SAR to 301.2 million SAR. Introducing VEN+G resulted in a budget increase over the first 3 years, then budget savings over years 4 and 5, resulting in an overall negative budget impact. Drug acquisition costs were the main value driver for cost change as VEN+G is usually prescribed during the first treatment year only unlike most other protocols which are prescribed for longer periods. DSA proved the model results were robust.

CONCLUSIONS: In Saudi Arabia, the introduction of the VEN+G for first line CLL represents a potential treatment approach. This introduction results in a marginal decrement in the budget over 5 years. However, it notably enhances patient satisfaction by reducing the duration of the treatment period (one-year fixed duration).