Using Real-World Evidence of BTK Inhibitors to Inform Coverage Decisions in CLL

Panelists discuss how real-world evidence (RWE) offers valuable insights for refining coverage policies in oncology, particularly for Bruton tyrosine kinase (BTK) inhibitor use in chronic lymphocytic leukemia (CLL). They explain that while clinical trials establish efficacy, RWE captures long-term safety, adherence, and patient tolerance data across diverse populations.

This information can help payers reassess restrictive step edits and prior authorization requirements that no longer reflect contemporary practice. Panelists highlight that incorporating RWE into coverage frameworks allows for more dynamic, evidence-responsive policies that improve care quality without compromising fiscal responsibility.

They emphasize that data transparency and standardization are key to enabling this evolution, urging collaboration between institutions, payers, and regulators to integrate real-world data into reimbursement decisions.