Ibrutinib (Imbruvica)

Abstract

CADTH recommends that ibrutinib, in combination with venetoclax, should be reimbursed by public drug plans for the treatment of adult patients with previously untreated chronic lymphocytic leukemia (CLL), including those with 17p deletion only if certain conditions are met. In combination with venetoclax, Ibrutinib should only be covered to treat adult (≥ 18 years) patients with previously untreated CLL, including those with 17p deletion. Patients receiving Imbruvica should be in relatively good health (i.e., have a good performance status, as determined by a specialist). Patients with major surgery within 4 weeks of the first dose of study treatment, bleeding disorder, central nervous system involvement, Richter syndrome, or uncontrolled autoimmune hemolytic anemia or thrombocytopenia should not be eligible for coverage. Imbruvica in combination with venetoclax should only be reimbursed if prescribed by hematologists or oncologists with expertise and experience in the treatment of CLL and monitoring of therapy and if the drug program cost of Imbruvica in combination with venetoclax does not exceed the drug program cost of treatment with the least costly comparator that is reimbursed for the treatment of CLL. Patients who experience disease progression while taking Imbruvica in combination with venetoclax or who cannot tolerate the drug would not be eligible for continued coverage.