A Comparative Pharmacoeconomic Analysis of the Use of Obinu-tuzumab and Ibrutinib in Patients with Chronic Lymphocytic Leukemia in a Program of Access to High-Cost Medicines
Goal. To evaluate economic efficiency of the use of obinutuzumab and ibrutinib in chronic lymphocytic leukemia (CLL) within the framework of access to high-cost medicines. Methods. A model was created to assess budgetary changes of the program of seven high-cost diseases (7HCD) after the inclusion of new drugs, i. e. obinutuzumab and ibrutinib. The model was based on clinical studies and a registry of patients with CLL, and considered costs of medications offered within the federal program. The number of patients who would gain access to new drugs in various versions of expanded list of medications was calculated, as well as additional costs associated with the use of these drugs in the changed modeled lists. The time horizon of the model was 3 years. Results. The inclusion of new drugs (obinutuzumab and ibrutinib) into 7HCD program would enable to effectively treat 652, 1328 and 2014 patients with CLL in the first, second and third year of the program, respectively. A separate modeling of costs for each of the new drugs showed that the burden of obinutuzumab was 482 million RUB (12,4%) lower for the budget of 7HCD program starting from the second year, and 2407 million RUB (41,5%) lower at the third year, compared with ibrutinib. This in turn will enable to provide effective treatment to a higher number of patients with CLL. Conclusion. If 7HCD program will be expanded with new drugs for patients with CLL, additional costs connected with the use of obinutuzumab will be lower in a long-term perspective compared to costs associated with the use of ibrutinib.