Economic Impact of Oral Therapies for Chronic Lymphocytic Leukemia-the Burden of Novelty

Curr Hematol Malig Rep. 2018 Aug;13(4):237-243. doi: 10.1007/s11899-018-0461-y.

Abstract

Purpose of review: Small molecule tyrosine kinase inhibitors (TKIs) and BCL2 inhibitors are oral targeted therapies that have changed the treatment approach to patients with chronic lymphocytic leukemia (CLL). The aim of this review is to summarize the relevant literature on the economic impact of oral novel therapies for the treatment of CLL and discuss the underlying factors and suggested solutions for high drug prices.

Recent findings: The cost of therapy for CLL has increased substantially since the introduction of oral therapies. This increase in cost is caused by multiple factors including cost of drug development, alternate reimbursement patterns, lack of transparency, and lack of free market competition. Oral therapies for CLL have dramatically increased costs for both patients and payers. Some solutions to overcome this include value-based pricing, transparency, and legal action that allow Medicare to negotiate drug prices with manufacturers.

Keywords: CLL; Drug costs; Ibrutinib; Idelalisib; Pharmacoeconomics, financial toxicity; Venetoclax.

Publication types

  • Review

MeSH terms

  • Administration, Oral
  • Costs and Cost Analysis
  • Drug Delivery Systems* / economics
  • Drug Delivery Systems* / methods
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell* / drug therapy
  • Leukemia, Lymphocytic, Chronic, B-Cell* / economics
  • Leukemia, Lymphocytic, Chronic, B-Cell* / enzymology
  • Protein Kinase Inhibitors* / economics
  • Protein Kinase Inhibitors* / therapeutic use
  • Proto-Oncogene Proteins c-bcl-2 / antagonists & inhibitors*

Substances

  • BCL2 protein, human
  • Protein Kinase Inhibitors
  • Proto-Oncogene Proteins c-bcl-2