Imbruvica is a Bruton’s Tyrosine Kinase (BTK) inhibitor that is often prescribed indefinately in some chronic lymphocytic leukemia (CLL) patients. While it has high-efficacy, its premium cost and long treatment duration is a huge burden on patients and caregivers. A better understanding of how drugs can be administered for finite treatment periods, without compromising efficacy, would help reduce this burden.
Imbruvica’s superior efficacy means that it is prescribed in favour of finite treatments such as Rituxan-based chemotherapies in certain populations of CLL patients. However, CLL patients receiving this therapy have to tolerate side effects and remember to regularly take their medication, while healthcare providers have to provide repeat prescriptions and manage side effects.
Indefinite treatment durations of expensive CLL drugs such as Imbruvica have helped to increase the size of the CLL market. Imbruvica’s Q1 sales for 2017 were $551m, representing growth of 44.7% compared to 2016. This has attracted a lot of interest from pharmaceutical companies looking to develop new and improved CLL treatments.
Imbruvica has greatly improved the median progression-free survival (PFS) in CLL patients and late-stage pipeline drugs are not expected to improve upon Imbruvica’s efficacy over shorter treatment durations. AstraZeneca and Acerta Pharma’s BTK inhibitor acalabrutinib is administered continuously to patients in all of its ongoing Phase II and III trials. Based on Phase II data, it appears to be better tolerated than Imbruvica. If acalabrutinib demonstrates similar efficacy to Imbruvica in its ongoing head-to-head Phase III trial, it will expand the use of BTK inhibitors in CLL patients and increase the number of patients getting indefinite treatments. GlobalData expects acalabrutinib to be priced similarly to Imbruvica, which means payers would face the same financial burdens of long treatment durations and premium cost.
GlobalData (2016). Immuno-Oncology Strategic Insight: Multi-Indication and Market Size Analysis, GDHC057POA