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Economic Burden Associated With BTK Inhibitor Use

Opinion
Video

Experts evaluate the financial impact experience by patients receiving BTK inhibitor therapy.

This is a video synopsis/summary of a Peer Exchange involving: Ryan Haumschild, PharmD, MS, MBA, CPEL; Tara Graff, DO, MS; Ryan Jacobs, MD; Deborah Stephens, DO; Jennifer Woyach, MD.

The group discusses the substantial financial burden and access challenges associated with Bruton tyrosine kinase (BTK) inhibitor therapy. These oral targeted therapies often have high monthly out-of-pocket costs in the thousands of dollars. It can take weeks to months for insurance approvals, which delays treatment initiation. Patient assistance programs and foundations provide invaluable help covering co-pays for those who qualify, but the application process can be cumbersome. Those who fall just above the financial qualification cutoffs struggle the most to afford these costly therapies. The group emphasizes the importance of a coordinated team to help patients navigate the complex financial assistance landscape.

Ongoing efforts to improve affordability and access include corporate co-pay programs, differential pricing across therapies, and policy-level changes like the Inflation Reduction Act, which will significantly lower out-of-pocket drug costs for Medicare beneficiaries. However, a provision allowing Medicare to negotiate prices directly with manufacturers resulted in ibrutinib being selected among the first 10 drugs. The impact this may have on restricting BTK inhibitor choice and accessibility for vulnerable patient subgroups who cannot tolerate ibrutinib is concerning. The group stresses treatment decisions should remain personalized based on patients’ medical histories. More data are needed to determine how Medicare negotiations will affect overall access and costs in chronic lymphocytic leukemia and small lymphocytic lymphoma.

Video synopsis is AI-generated and reviewed by AJMC® editorial staff.

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