{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T12:27:14Z","timestamp":1777984034790,"version":"3.51.4"},"reference-count":50,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100006483","name":"AbbVie","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006483","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>The GAIA\u2010CLL13 trial showed that venetoclax\u2010obinutuzumab (Ven\u2010O) based regimens, with or without ibrutinib, offer superior efficacy compared to chemoimmunotherapy (CIT) with regards to progression free survival (PFS) in fit, treatment\u2010na\u00efve (TN) CLL patients. However, their higher costs warrant a cost\u2010effectiveness evaluation. This study assessed the cost\u2010effectiveness of Ven\u2010O versus venetoclax with rituximab (Ven\u2010R), venetoclax\u2010obinutuzumab\u2010ibrutinib (Ven\u2010O\u2010I), and CIT in fit, TN CLL patients without TP53 aberrations across the Netherlands, Norway, and Denmark. A state\u2010transition Markov model including later line treatment was applied to estimate costs, life years (LYs), and quality\u2010adjusted life years (QALYs) over a 38\u2010year horizon. Results were sensitive to long\u2010term OS assumptions. In the base\u2010case analysis, extrapolating OS and PFS for each treatment separately, all venetoclax\u2010based treatments appeared cost\u2010effective compared to CIT in all three countries. ICERs for Ven\u2010R, Ven\u2010O, and Ven\u2010O\u2010I versus CIT were \u20ac35\u2009840, \u20ac32\u2009513, \u20ac30\u2009331 for the Netherlands, \u20ac39\u2009881, \u20ac38\u2009099, \u20ac26\u2009381 for Norway, and \u20ac34\u2009010, \u20ac37\u2009804, \u20ac33\u2009215 for Denmark. In the sensitivity analyses, however, cost\u2010effectiveness was lost when only allowing separate OS and PFS extrapolations for statistically significant differences at 60\u2010month follow\u2010up. Furthermore, cost\u2010effectiveness results were sensitive to varying assumptions about national willingness\u2010to\u2010pay (WTP) thresholds, IGHV\u2010status, and time horizon. In conclusion, venetoclax\u2010based treatments may be considered a cost\u2010effective treatment option for fit, TN CLL patients without TP53 aberrations in the Netherlands, Norway, and Denmark, but the pricing process for targeted agents should take the uncertainty about cost\u2010effectiveness into account when negotiating pricing of medication. Longer follow\u2010up data is needed to address the uncertainties.<\/jats:p>","DOI":"10.1111\/ejh.70143","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T08:17:04Z","timestamp":1772957824000},"page":"873-882","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cost\u2010Effectiveness of Venetoclax\u2010Based Treatment in Treatment\u2010Na\u00efve Fit Patients With\n                    <scp>CLL<\/scp>\n                    Without\n                    <scp>TP53<\/scp>\n                    Aberrations"],"prefix":"10.1111","volume":"116","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6512-5566","authenticated-orcid":false,"given":"Lars Holger","family":"Ehlers","sequence":"first","affiliation":[{"name":"Nordic Institute of Health Economics  Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2139-3547","authenticated-orcid":false,"given":"Mark\u2010David","family":"Levin","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Albert Schweitzer Hospital  Dordrecht the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3333-1327","authenticated-orcid":false,"given":"Marjolein","family":"van der Klift","sequence":"additional","affiliation":[{"name":"Department of Haematology Amphia Hospital  Breda the Netherlands"},{"name":"Medicine, Erasmus University Medical Center  Rotterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9455-0104","authenticated-orcid":false,"given":"Morten Berg","family":"Jensen","sequence":"additional","affiliation":[{"name":"Nordic Institute of Health Economics  Aarhus Denmark"},{"name":"Department of Economics Aarhus University  Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6318-3356","authenticated-orcid":false,"given":"Hoa Thi Tuyet","family":"Tran","sequence":"additional","affiliation":[{"name":"Department of Haematology Akershus University Hospital  Oslo Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3190-1891","authenticated-orcid":false,"given":"Arnon P.","family":"Kater","sequence":"additional","affiliation":[{"name":"Department of Haematology Amsterdam University Medical Centers  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9880-5242","authenticated-orcid":false,"given":"Carsten Utoft","family":"Niemann","sequence":"additional","affiliation":[{"name":"Department of Haematology, Rigshospitalet  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,25]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2020.09.019"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2213093"},{"key":"e_1_2_11_4_1","volume-title":"New Study Confirms Economic Burden of Chronic Lymphocytic Leukemia on Medicare Beneficiaries","author":"Weiser P.","year":"2024"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2024.06.016"},{"key":"e_1_2_11_6_1","volume-title":"Kronisk Lymfatisk Leuk\u00e6mi (CLL) og sm\u00e5cellet lymfocyt\u00e6r lymfom (SLL)","author":"Danske Multidisciplin\u00e6re Cancer Grupper","year":"2022"},{"key":"e_1_2_11_7_1","unstructured":"Helsedirektoratet \u201cBehandlingsveiledning KLL. 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