{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T12:32:57Z","timestamp":1791808377769,"version":"4.3.4"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2021,11,10]],"date-time":"2021-11-10T00:00:00Z","timestamp":1636502400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,11,10]],"date-time":"2021-11-10T00:00:00Z","timestamp":1636502400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"AbbVie AG"},{"DOI":"10.13039\/100008375","name":"University of Basel","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100008375","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Health Econ"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction<\/jats:title>\n                <jats:p>Venetoclax in combination with rituximab (VEN\u2009+\u2009R) demonstrated prolonged overall survival (OS) and progression-free survival (PFS) for patients with relapsed\/refractory (R\/R) chronic lymphocytic leukemia (CLL) in comparison to standard chemoimmunotherapy [bendamustine\u2009+\u2009rituximab (BR)]. We conducted a cost-effectiveness and budget impact analysis comparing VEN\u2009+\u2009R versus six comparators from the Swiss healthcare payer perspective.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A three-state partitioned survival model, developed in accordance with NICE and ISPOR decision modelling guidelines, was adapted to Switzerland. Model inputs were informed by the MURANO trial (survival data, patient characteristics), publicly available Swiss sources (drug prices, inpatient and outpatient costs), Swiss National Institute of Cancer Epidemiology and Registration data (incidence and prevalence values), and Swiss medical expert feedback. We used published (dis-)utility values and adverse event probabilities.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Over a lifetime, VEN\u2009+\u2009R resulted in an expected gain of 2.60 quality-adjusted life years (QALYs) per patient and incremental costs of Swiss Francs (CHF)\u00a0147,851 compared to BR, leading to an incremental cost-effectiveness ratio of CHF\u00a056,881\/QALY gained. Other treatment strategies (for example ibrutinib versus VEN\u2009+\u2009R) resulted in higher costs and lower QALYs. Results were not different for subgroups of patients with\/without deletion of chromosome 17p\/tumour protein 53 mutation. In scenario analysis, changes in post-progression treatment costs demonstrated a high impact on results. We estimated an expected value of perfect information of CHF\u00a03,318\/patient. A moderate VEN\u2009+\u2009R uptake was estimated to save CHF 12.3 million during 5\u00a0years.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Using a threshold of CHF 100,000 per QALY, VEN\u2009+\u2009R was projected to be cost-effective vs BR.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s10198-021-01398-7","type":"journal-article","created":{"date-parts":[[2021,11,10]],"date-time":"2021-11-10T12:11:53Z","timestamp":1636546313000},"page":"837-846","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Cost-effectiveness and budget impact of venetoclax in combination with rituximab in relapsed\/refractory chronic lymphocytic leukemia in Switzerland"],"prefix":"10.1007","volume":"23","author":[{"given":"Michaela","family":"Barbier","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Durno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig","family":"Bennison","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias","family":"\u00d6rtli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Knapp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Schwenkglenks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,11,10]]},"reference":[{"key":"1398_CR1","doi-asserted-by":"publisher","first-page":"16096","DOI":"10.1038\/nrdp.2016.96","volume":"3","author":"TJ Kipps","year":"2017","unstructured":"Kipps, T.J., et al.: Chronic lymphocytic leukaemia. Nat. Rev. Dis. Primers 3, 16096 (2017)","journal-title":"Nat. Rev. Dis. Primers"},{"key":"1398_CR2","doi-asserted-by":"publisher","first-page":"v78","DOI":"10.1093\/annonc\/mdv303","volume":"26","author":"B Eichhorst","year":"2015","unstructured":"Eichhorst, B., et al.: Chronic lymphocytic leukaemia: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann. Oncol. 26, v78\u2013v84 (2015)","journal-title":"Ann. Oncol."},{"issue":"11","key":"1398_CR3","doi-asserted-by":"publisher","first-page":"1266","DOI":"10.1002\/ajh.25595","volume":"94","author":"M Hallek","year":"2019","unstructured":"Hallek, M.: Chronic lymphocytic leukemia: 2020 update on diagnosis, risk stratification and treatment. Am. J. Hematol. 94(11), 1266\u20131287 (2019)","journal-title":"Am. J. Hematol."},{"issue":"2","key":"1398_CR4","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1016\/j.critrevonc.2008.01.013","volume":"67","author":"JF Piccirillo","year":"2008","unstructured":"Piccirillo, J.F., et al.: The changing prevalence of comorbidity across the age spectrum. Crit. Rev. Oncol. Hematol. 67(2), 124\u2013132 (2008)","journal-title":"Crit. Rev. Oncol. Hematol."},{"issue":"12","key":"1398_CR5","doi-asserted-by":"publisher","first-page":"1107","DOI":"10.1056\/NEJMoa1713976","volume":"378","author":"JF Seymour","year":"2018","unstructured":"Seymour, J.F., et al.: Venetoclax-rituximab in relapsed or refractory chronic lymphocytic leukemia. N. Engl. J. Med. 378(12), 1107\u20131120 (2018)","journal-title":"N. Engl. J. Med."},{"issue":"3","key":"1398_CR6","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1056\/NEJMoa1400376","volume":"371","author":"JC Byrd","year":"2014","unstructured":"Byrd, J.C., et al.: Ibrutinib versus ofatumumab in previously treated chronic lymphoid leukemia. N. Engl. J. Med. 371(3), 213\u2013223 (2014)","journal-title":"N. Engl. J. Med."},{"key":"1398_CR7","doi-asserted-by":"publisher","first-page":"7510","DOI":"10.1200\/JCO.2017.35.15_suppl.7510","volume":"35","author":"JC Byrd","year":"2017","unstructured":"Byrd, J.C., et al.: Long-term efficacy and safety with ibrutinib (ibr) in previously treated chronic lymphocytic leukemia (CLL): up to four years follow-up of the RESONATE study. J. Clin. Oncol. 35, 7510\u20137510 (2017). (15_suppl)","journal-title":"J. Clin. Oncol."},{"issue":"11","key":"1398_CR8","doi-asserted-by":"publisher","first-page":"997","DOI":"10.1056\/NEJMoa1315226","volume":"370","author":"RR Furman","year":"2014","unstructured":"Furman, R.R., et al.: Idelalisib and rituximab in relapsed chronic lymphocytic leukemia. N. Engl. J. Med. 370(11), 997\u20131007 (2014)","journal-title":"N. Engl. J. Med."},{"issue":"21","key":"1398_CR9","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1182\/blood.V124.21.330.330","volume":"124","author":"JP Sharman","year":"2014","unstructured":"Sharman, J.P., et al.: Second interim analysis of a phase 3 study of idelalisib (ZYDELIG\u00ae) plus rituximab (R) for relapsed chronic lymphocytic leukemia (CLL): efficacy analysis in patient subpopulations with Del(17p) and other adverse prognostic factors. Blood 124(21), 330\u2013330 (2014)","journal-title":"Blood"},{"issue":"2","key":"1398_CR10","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1016\/S1470-2045(15)00465-9","volume":"17","author":"A Chanan-Khan","year":"2016","unstructured":"Chanan-Khan, A., et al.: Ibrutinib combined with bendamustine and rituximab compared with placebo, bendamustine, and rituximab for previously treated chronic lymphocytic leukaemia or small lymphocytic lymphoma (HELIOS): a randomised, double-blind, phase 3 study. Lancet Oncol. 17(2), 200\u2013211 (2016)","journal-title":"Lancet Oncol."},{"issue":"11","key":"1398_CR11","doi-asserted-by":"publisher","first-page":"3016","DOI":"10.1182\/blood-2010-08-304683","volume":"117","author":"XC Badoux","year":"2011","unstructured":"Badoux, X.C., et al.: Fludarabine, cyclophosphamide, and rituximab chemoimmunotherapy is highly effective treatment for relapsed patients with CLL. Blood 117(11), 3016\u20133024 (2011)","journal-title":"Blood"},{"issue":"6","key":"1398_CR12","doi-asserted-by":"publisher","first-page":"768","DOI":"10.1016\/S1470-2045(16)30019-5","volume":"17","author":"S Stilgenbauer","year":"2016","unstructured":"Stilgenbauer, S., et al.: Venetoclax in relapsed or refractory chronic lymphocytic leukaemia with 17p deletion: a multicentre, open-label, phase 2 study. Lancet Oncol. 17(6), 768\u2013778 (2016)","journal-title":"Lancet Oncol."},{"issue":"4","key":"1398_CR13","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1056\/NEJMoa1513257","volume":"374","author":"AW Roberts","year":"2016","unstructured":"Roberts, A.W., et al.: Targeting BCL2 with venetoclax in relapsed chronic lymphocytic leukemia. N. Engl. J. Med. 374(4), 311\u2013322 (2016)","journal-title":"N. Engl. J. Med."},{"key":"1398_CR14","unstructured":"National Institute for Health and Care Excellence (NICE), Guide to the Methods of Technology Appraisal 2013 [Internet]. 2013."},{"key":"1398_CR15","unstructured":"Woods, B., et al.: NICE DSU technical support document 19: partitioned survival analysis for decision modelling in. 2017. http:\/\/nicedsu.org.uk\/wp-content\/uploads\/2017\/06\/Partitioned-Survival-Analysis-final-report.pdf"},{"issue":"1","key":"1398_CR16","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1046\/j.1524-4733.2003.00234.x","volume":"6","author":"MC Weinstein","year":"2003","unstructured":"Weinstein, M.C., et al.: Principles of good practice for decision analytic modeling in health-care evaluation: report of the ISPOR task force on good research practices\u2014modeling studies. Value Health 6(1), 9\u201317 (2003)","journal-title":"Value Health"},{"key":"1398_CR17","unstructured":"National Institute for Health and Care Excellence, Single technology appraisal: venetoclax in combination with rituximab for treating relapsed or refractory chronic lymphocytic leukaemia [ID1097]. 2018. https:\/\/www.nice.org.uk\/guidance\/ta561\/documents\/committee-papers"},{"key":"1398_CR18","unstructured":"Durno, N., et al.: Cost-effectiveness of a 24-month fixed duration of venetoclax in combination with rituximab in relapsed\/refractory chronic lymphocytic leukemia. Poster at the international workshop on CLL 2019. https:\/\/www.iwcll2019.org\/wp-content\/uploads\/2019\/09\/iwCLL-Abstract-Titles.pdf (Presentation ID=2070)"},{"key":"1398_CR19","unstructured":"Swiss Federal Office for Public Health (\u201cBAG\u201d). Analysis list of 1.7.2020. Available from: https:\/\/www.bag.admin.ch\/bag\/de\/home\/versicherungen\/krankenversicherung\/krankenversicherung-leistungen-tarife\/Analysenliste.html. Accessed 7 Sept 2020"},{"key":"1398_CR20","unstructured":"TARMED Online Browser. Available from: https:\/\/www.tarmed-browser.ch\/de\/leistungen\/00.2285-nicht-formalisierter-bericht-11-bis-35-zeilen-text. Accessed 4 Aug 2020"},{"key":"1398_CR21","unstructured":"Swiss Federal Office. Spezialit\u00e4tenliste. Available from: http:\/\/www.spezialitaetenliste.ch\/ShowPreparations.aspx. Accessed 5 Aug 2020"},{"key":"1398_CR22","unstructured":"SwissDRG AG. Online Definitionshandbuch SwissDRG 9.0 Abrechnungsversion. Available from: https:\/\/manual90.swissdrg.org\/. Accessed 4 Aug 2020"},{"key":"1398_CR23","unstructured":"Swiss Federal Statistical Office. Mean body height (in cm). Available from: https:\/\/www.bfs.admin.ch\/bfs\/en\/home\/statistics\/health.assetdetail.7586022.html. Accessed 2 Sept 2020"},{"key":"1398_CR24","unstructured":"Swiss Federal Statistical Office. Mean body weight (in kg). Available from: https:\/\/www.bfs.admin.ch\/bfs\/de\/home\/statistiken\/gesundheit.assetdetail.7586025.html"},{"key":"1398_CR25","unstructured":"ClinicalTrials.gov, A phase 2 open-label study of the efficacy and safety of ABT-199 (GDC-0199) in chronic lymphocytic leukemia (CLL) subjects with relapse or refractory to B-cell receptor signalling pathway inhibitor therapy [NCT02141282]. Available from: https:\/\/www.clinicaltrials.gov\/ct2\/show\/NCT02141282. Accessed 1 July 2020"},{"key":"1398_CR26","doi-asserted-by":"publisher","DOI":"10.1093\/med\/9780199685028.001.0001","volume-title":"Economic evaluation in clinical trials","author":"HA Glick","year":"2014","unstructured":"Glick, H.A., et al.: Economic evaluation in clinical trials. OUP, Oxford (2014)"},{"issue":"5","key":"1398_CR27","doi-asserted-by":"publisher","first-page":"669","DOI":"10.1007\/s10198-021-01282-4","volume":"22","author":"MC Barbier","year":"2021","unstructured":"Barbier, M.C., et al.: A cost-effectiveness analysis of pembrolizumab with or without chemotherapy for the treatment of patients with metastatic, non-squamous non-small cell lung cancer and high PD-L1 expression in Switzerland. Eur. J. Health Econ. 22(5), 669\u2013677 (2021)","journal-title":"Eur. J. Health Econ."},{"issue":"4","key":"1398_CR28","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1016\/j.annonc.2020.01.007","volume":"31","author":"CM Panje","year":"2020","unstructured":"Panje, C.M., et al.: A cost-effectiveness analysis of consolidation immunotherapy with durvalumab in stage III NSCLC responding to definitive radiochemotherapy in Switzerland. Ann. Oncol. 31(4), 501\u2013506 (2020)","journal-title":"Ann. Oncol."},{"key":"1398_CR29","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1186\/1471-2407-14-306","volume":"14","author":"KW Matter-Walstra","year":"2014","unstructured":"Matter-Walstra, K.W., et al.: Delivery of health care at the end of life in cancer patients of four swiss cantons: a retrospective database study (SAKK 89\/09). BMC Cancer 14, 306 (2014)","journal-title":"BMC Cancer"},{"key":"1398_CR30","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1182\/blood-2019-123930","volume":"134","author":"JF Seymour","year":"2019","unstructured":"Seymour, J.F., et al.: Four-year analysis of murano study confirms sustained benefit of time-limited venetoclax-rituximab (VenR) in relapsed\/refractory (R\/R) chronic lymphocytic leukemia (CLL). Blood 134, 355\u2013355 (2019). (Supplement_1)","journal-title":"Blood"},{"key":"1398_CR31","unstructured":"National Institute for Health and Care Excellence, TA487: Venetoclax for treating chronic lymphocytic leukaemia [ID944] (2017). https:\/\/www.nice.org.uk\/guidance\/ta487\/documents\/committee-papers"},{"key":"1398_CR32","unstructured":"National Institute for Health and Care Excellence, TA359: Idelalisib for treating chronic lymphocytic leukaemia (2015). https:\/\/www.nice.org.uk\/guidance\/TA359\/documents\/leukaemia-chronic-lymphocytic-previously-treated-idelalisib-id764-final-appraisal-determination-document2"},{"key":"1398_CR33","doi-asserted-by":"publisher","first-page":"LBA-2","DOI":"10.1182\/blood.V130.Suppl_1.LBA-2.LBA-2","volume":"130","author":"JF Seymour","year":"2017","unstructured":"Seymour, J.F., et al.: Venetoclax plus rituximab is superior to bendamustine plus rituximab in patients with relapsed\/refractory chronic lymphocytic leukemia\u2014results from pre-planned interim analysis of the randomized phase 3 murano study. Blood 130, LBA-2 (2017)","journal-title":"Blood"},{"key":"1398_CR34","unstructured":"HCI solutions AG. Compendium.ch. Available from: https:\/\/compendium.ch\/search\/products. Accessed 5 Aug 2020"},{"key":"1398_CR35","unstructured":"Blutspende SRK Z\u00fcrich. Blutspende Z\u00fcrich Preisliste Version 1\/2019. Available from: https:\/\/www.blutspendezurich.ch\/fileadmin\/pdf\/BSZ_Preisliste_1_2019.pdf. Accessed 4 Aug 2020"},{"key":"1398_CR36","unstructured":"Deutsche Gesellschaft f\u00fcr H\u00e4matologie und Medizinische Onkologie e.V. Onkopedia Leitlinie Chronische Lymphatische Leuk\u00e4mie (CLL). Available from: https:\/\/www.onkopedia.com\/de\/onkopedia\/guidelines\/chronische-lymphatische-leukaemie-cll\/@@guideline\/html\/index.html. Accessed 17 Aug 2020"},{"key":"1398_CR37","unstructured":"National Institute for Cancer Epidemiology and Registration. Available from: https:\/\/www.nicer.org\/. Accessed 4 Dec 2020"},{"issue":"1","key":"1398_CR38","doi-asserted-by":"publisher","first-page":"P23","DOI":"10.1016\/j.annonc.2020.09.019","volume":"32","author":"B Eichhorst","year":"2020","unstructured":"Eichhorst, B., et al.: Chronic lymphocytic leukaemia: ESMO clinical practice guidelines for diagnosis, treatment and follow-up\u2020. Ann. Oncol. 32(1), P23\u2013P33 (2020). https:\/\/doi.org\/10.1016\/j.annonc.2020.09.019","journal-title":"Ann. Oncol."},{"key":"1398_CR39","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2019.04.246","author":"SF Huntington","year":"2019","unstructured":"Huntington, S.F., et al.: PCN122 cost-effectiveness of a 24-month fixed duration of venetoclax in combination with rituximab in relapsed or refractory chronic lymphocytic leukemia in the United States. Value Health (2019). https:\/\/doi.org\/10.1016\/j.jval.2019.04.246","journal-title":"Value Health"},{"key":"1398_CR40","doi-asserted-by":"publisher","first-page":"2139","DOI":"10.1182\/blood-2019-121490","volume":"134","author":"JF Elgart","year":"2019","unstructured":"Elgart, J.F., et al.: Cost-effectiveness of venetoclax and rituximab combination therapy in relapsed\/refractory chronic lymphocytic leukemia (CLL) in Argentina. Blood 134, 2139 (2019). https:\/\/doi.org\/10.1182\/blood-2019-121490","journal-title":"Blood"}],"container-title":["The European Journal of Health Economics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10198-021-01398-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10198-021-01398-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10198-021-01398-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,6,7]],"date-time":"2022-06-07T19:39:09Z","timestamp":1654630749000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10198-021-01398-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,10]]},"references-count":40,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2022,7]]}},"alternative-id":["1398"],"URL":"https:\/\/doi.org\/10.1007\/s10198-021-01398-7","relation":{},"ISSN":["1618-7598","1618-7601"],"issn-type":[{"value":"1618-7598","type":"print"},{"value":"1618-7601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,10]]},"assertion":[{"value":"27 May 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 October 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 November 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"MS received research funding from AbbVie via employment institution, from which MB was partially funded. ND and CB received consulting fees from AbbVie. MO and CK are employed at AbbVie.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}