The move means patients could live treatment-free after 15 months of therapy.
Patients newly diagnosed with chronic lymphocytic leukaemia and small lymphocytic lymphoma can now access a fixed-duration combination of ibrutinib and venetoclax tablets through the PBS.
The change, which came into effect at the start of the month, will see general patients pay $31.60 per month and concession card holders just $7.70, amounting to $474 and $115.50 for the 15 months of treatment – well short of the $190,000-plus figure patients had to pay prior to the subsidy.
The Pharmaceutical Benefits Advisory Committee’s decision, which was made in their March 2024 meeting, was “based on, among other matters, its assessment that the cost-effectiveness of ibrutinib plus venetoclax would be acceptable if it were cost-minimised against venetoclax in combination with obinutuzumab”.
Using fixed-term duration therapy is a novel approach to treating blood and bone marrow cancers, said Alfred Health’s head of lymphoma services Professor Con Tam.
As part of the new approach, patients take one ibrutinib tablet per day for three months (which slows tumour growth and increases the body’s response to venetoclax), followed by 12 months of ibrutinib and venetoclax tablets (where the latter therapy interferes with how the cancer cells protect themselves against the immune system, leading to cell death).
“The traditional response to this and most forms of cancer is to treat until the cancer progresses. This often means that people receive treatment for many years, which can be costly, increase the likelihood of side-effects and become mentally gruelling,” Professor Tam said in a statement.
“Now, we can tell patients at the outset that this treatment will be taken at home and last for 15 months. It’s an exciting new era and we thank the Federal Health Minister for making this combination therapy available on the PBS.”
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Professor Tam was hopeful the fixed-duration therapy, which involves two treatments working in a synergistic fashion, would allow cancer patients “to live life as closely as possible to normal”.
“CLL usually progresses slowly, so for patients it’s akin to living with a long-term illness. Most patients remain on treatments of one form or another for many years,” said the dual-trained haematologist and haematopathologist.
Sharon Winton, CEO of Lymphoma Australia, said the move was “amazing news” for the 2000-odd people diagnosed with these cancers each year.
“The long-term treatment of CLL/SLL can take a significant emotional, physical and financial toll,” she told media.
“Affordable access to a new all-oral fixed-duration therapy is amazing news for the lymphoma and leukaemia communities.”
