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Budgetary Impact of Bendamustine Ready-to-Dilute Products in Chronic Lymphocytic Leukemia and Non-Hodgkin Lymphoma to a United States Infusion Facility

Authors James E, Trautman H, Thompson S, Ribalov R, Choudhry A

Received 6 January 2021

Accepted for publication 5 March 2021

Published 22 March 2021 Volume 2021:13 Pages 201—211


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Samer Hamidi

Elizabeth James,1 Holly Trautman,1 Stephen Thompson,2 Rinat Ribalov,3 Azhar Choudhry4

1Aventine Consulting LLC, Marblehead, MA, USA; 2Global Health Economics and Outcomes Research, Teva Branded Pharmaceutical Products R&D, Inc, Parsippany, NJ, USA; 3Global Health Economics and Outcomes Research, Teva Pharmaceutical Industries Ltd, Petah Tikva, Israel; 4Medical Affairs, Teva Branded Pharmaceutical Products R&D, Inc, Parsippany, NJ, USA

Correspondence: Elizabeth James Tel +1 425 290 2148
Email [email protected]

Background: Bendamustine hydrochloride (BND HCl) is indicated for first-line treatment of chronic lymphocytic leukemia (CLL) and rituximab-refractory indolent non-Hodgkin lymphoma (iNHL). There are two ready-to-dilute (RTD) formulations of BND HCl on the US market: a large-volume, long-duration infusion (BND-L) and a small-volume, short-duration infusion (BND-S). It is estimated that the shorter duration infusion could result in cost savings to infusion facilities.
Objective: Estimate the one-year budget impact between BND-S and BND-L for use in the treatment of CLL and iNHL when all current BND-L utilization is replaced with BND-S, from the US infusion facility perspective.
Methods: An illustrative budget impact model estimated the change in costs associated with a projected increase from 50% to 100% market share for BND-S. The model included CLL and iNHL patient populations. Budgetary costs reflected facility expenditures on drug acquisition and administration based on recommended dosing for BND-S and BND-L. The base-case model assumptions and inputs were derived from scientific literature and publicly available resources. The total budget impact was calculated annually, along with the differences in per patient cost; one-way sensitivity analyses were conducted.
Results: Per-patient savings with BND-S use after the utilization shift were estimated at $2812.24 for CLL and $4769.01 for iNHL. Across both indications, the total annual incremental savings after the utilization shift were estimated at $452,209 for 250 CLL and iNHL patients in a 10,000-patient infusion facility, resulting in cost savings of $150.74 per BND HCI patient per month and $1808.84 per BND HCI patient per year. The model was sensitive to changes in proportion of patients receiving BND HCI infusions for CLL and iNHL, patient body surface area, and BND-S wholesale acquisition cost.
Conclusion: This analysis estimated over $450,000 in annual savings for a 10,000-patient chemotherapy infusion facility following a utilization shift from 50% use of each RTD product to 100% use of BND-S in CLL and iNHL patients, driven by lower acquisition costs for BND-S and lower administration labor costs associated with rapid infusion.

Keywords: chronic lymphocytic leukemia, indolent non-Hodgkin lymphoma, budget impact, bendamustine, infusion

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