ASH 2023: Total Lifetime Costs of Treating Chronic Lymphocytic Leukemia are High

Treatment advances in chronic lymphocytic leukemia (CLL) have improved outcomes for people living with this disease. Relapses remain common, though, and people with CLL often receive multiple lines of costly therapies in their lifestyle. In this study, presented by LRF grantee Farrukh Awan, MD of University of Texas Southwestern Medical Center, researchers aimed to estimate the total lifetime cost of care for patients with CLL living in the United States.

Total cost estimates were based on a variety of factors, including treatment costs, survival and progression outcomes, and in-patient oncology care. Other factors were also considered, including emergency visits and end-of-life care.

Using survival data for the literature, researchers estimated that the average time spent in CLL care was about 8 years. The majority of that time (6 years on average) was spent in first-line treatment, with shorter intervals spent in subsequent lines of therapy. Treatment costs increased across later lines of therapy, from $140,867 per person per year in first-line treatment to an estimated $234,807 per year per year in the fifth line of treatment.

In total, researchers estimated that the total lifetime cost of CLL care in the United States is about $1,142,357. The majority of these costs (about 77%) were related to drug acquisition and administration; inpatient and emergency department visits accounted for about 20% of total costs. High drug costs were primarily driven by the costs of oral targeted therapies, including Bruton tyrosine kinase inhibitors such as ibrutinib and acalabrutinib, along with venetoclax.

The researchers concluded that these results demonstrate that there is a financial need for more effective therapies that limit treatment costs and progression into later – and more expensive – lines of therapy