The Budget Impact of Venetoclax Plus Obinutuzumab for First-Line Chronic Lymphocytic Leukemia in Saudi Arabia
Author(s)
M. Alrajhi A1, Al-Abdulkarim H2, Khan M3, Alkhudair N4, Alshehri H5, Fasseeh A6, Abd-El Aziz A7, Elezbawy B8, Abaza S9, Ahmed Y7, N Sheriba A10, Semida A10, AlNajjar F5
11) Clinical Pharmacy Department, King Fahad Medical City, 2)Department of Pharmacy Practice, College of Pharmacy, AlFaisal University, Riyadh, Saudi Arabia, 2National Guard Health Affairs, Riyadh, Riyadh, Saudi Arabia, 3Ministry of National Guards Health Affairs, Riyadh, Saudi Arabia, 4College of Pharmacy, King Saud University, Riyadh, Saudi Arabia, 5King Fahad Medical City, Riyadh, Saudi Arabia, 61) Faculty of Pharmacy Alexandria University 2) Syreon Middle East, Alexandria, Egypt, 7Syreon Middle East, Alexandria, Egypt, 81) Semmelweis University, Hungary; 2) Syreon Middle East, Alexandria, ALX, Egypt, 9Syreon Middle East, Cairo, Egypt, 10AbbVie Biopharmaceuticals GmbH, Riyadh, Saudi Arabia
Presentation Documents
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).
Conference/Value in Health Info
Value in Health, Volume 27, Issue 12, S2 (December 2024)
Code
EE700
Topic
Economic Evaluation, Study Approaches
Topic Subcategory
Budget Impact Analysis, Decision Modeling & Simulation
Disease
Drugs, Oncology