Analysis of venetoclax for first-line treatment of chronic lymphocytic leukaemia or small lymphocytic lymphoma, September 2023

Drug utilisation sub-committee (DUSC)

September 2023

Abstract

Purpose

To compare the predicted and actual utilisation of venetoclax for first-line treatment of chronic lymphocytic leukaemia (CLL) or small lymphocytic lymphoma (SLL) since its listing on the Pharmaceutical Benefits Scheme (PBS) and how the listing effected the second-line treatments for CLL and SLL.

Date of listing on the Pharmaceutical Benefits Scheme (PBS)

Venetoclax in combination with obinutuzumab was listed for first-line treatment for CLL or SLL on 1 December 2020.

Data Source / methodology

Data extracted from the PBS database maintained by Department of Health and Aged Care, processed by Services Australia were used for the analyses.

Key Findings

The actual uptake of venetoclax in combination with obinutuzumab for first-line treatment of CLL/SLL was different over the first two years of listing than predicted.
The actual substitution rate of chlorambucil in combination with obinutuzumab for venetoclax in first-line therapy is different than predicted over the first two years of listing.
The overall use of second-line therapies for CLL/SLL appears to have remained stable since the listing of venetoclax for first-line therapy. However, there appears to be a shift away from the use of ibrutinib towards venetoclax (as either monotherapy or in combination with rituximab) and to a lesser extent acalabrutinib for second-line therapy.
The median time on treatment including breaks in supply was estimated to be 360 days and excluding breaks was estimated to be 315 days.

Full Report