{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T22:50:58Z","timestamp":1772059858949,"version":"3.50.1"},"reference-count":71,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2024,9,17]],"date-time":"2024-09-17T00:00:00Z","timestamp":1726531200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"AbbVie Corporation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Bruton tyrosine kinase inhibitors (BTKis) represent an advancement in chronic lymphocytic leukemia; however, these agents are administered continuously until disease progression or unacceptable toxicity, raising concerns about their affordability. Venetoclax in combination with obinutuzumab (VO) is a fixed-duration (12-month) treatment, approved in Canada in 2020. This study estimated the total cumulative cost of different treatment sequences and evaluated the economic impact of introducing treatment sequences with\/without VO, from a Canadian health care system perspective. Methods: A 10-year partitioned survival model was developed, considering key clinical parameters and direct medical costs. Results were stratified by TP53 aberration. Results: Treatment sequences starting with first-line (1L) VO resulted in lower 10-year cumulative costs compared to sequences starting with BTKis administered until disease progression, across both TP53 aberration subgroups. With a maximum of three lines of treatment over a 10-year period, cumulative costs were largely determined by the first two lines of treatment. When comparing sequences with the same 1L treatment, sequences with BTKis in second-line incurred greater costs compared to fixed-duration regimens. Conclusions: Overall, the economic impact of treating all patients with VO led to 10-year cumulative savings of CAD 169,341 and CAD 293,731 per patient, without and with TP53 aberration, respectively. These savings are mainly due to reductions in treatment costs associated with fixed treatment duration.<\/jats:p>","DOI":"10.3390\/cancers16183182","type":"journal-article","created":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T00:51:43Z","timestamp":1726620703000},"page":"3182","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Economic Impact of Treatment Sequencing in Chronic Lymphocytic Leukemia in Canada Using Venetoclax plus Obinutuzumab"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5245-1178","authenticated-orcid":false,"given":"Kimberly","family":"Guinan","sequence":"first","affiliation":[{"name":"PeriPharm Inc., Montreal, QC H2Y 2H4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karine","family":"Mathurin","sequence":"additional","affiliation":[{"name":"PeriPharm Inc., Montreal, QC H2Y 2H4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0791-2518","authenticated-orcid":false,"given":"Jean","family":"Lachaine","sequence":"additional","affiliation":[{"name":"PeriPharm Inc., Montreal, QC H2Y 2H4, Canada"},{"name":"Faculty of Pharmacy, University of Montreal, Montreal, QC H3T 1J4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy Paul","family":"Roc","sequence":"additional","affiliation":[{"name":"AbbVie Corporation, Saint-Laurent, QC H4S 1Z1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah-Jane","family":"Bull","sequence":"additional","affiliation":[{"name":"AbbVie Corporation, Saint-Laurent, QC H4S 1Z1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4849-2442","authenticated-orcid":false,"given":"Dipti","family":"Tankala","sequence":"additional","affiliation":[{"name":"AbbVie Corporation, Saint-Laurent, QC H4S 1Z1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephane","family":"Barakat","sequence":"additional","affiliation":[{"name":"AbbVie Corporation, Saint-Laurent, QC H4S 1Z1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beenish S.","family":"Manzoor","sequence":"additional","affiliation":[{"name":"AbbVie Inc., North Chicago, IL 60064, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Hillis","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, McMaster University, Hamilton, ON L8S 4L8, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7415-8818","authenticated-orcid":false,"given":"Versha","family":"Banerji","sequence":"additional","affiliation":[{"name":"CancerCare Manitoba Research Institute, Winnipeg, MB R3E 0V9, Canada"},{"name":"Departments of Internal Medicine and Biochemistry & Medical Genetics, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R3E 0W2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,17]]},"reference":[{"key":"ref_1","unstructured":"Leukemia and Lymphoma Society of Canada (2021, December 01). 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