TABLE 1.

Key Input Data

Parameter	Base case value	Reference
Preprogression health state utility (all treatments)	0.670	NICE TA34333
Postprogression health state utility (all treatments)	0.600	NICE TA34333
End-of-life costs	$19,695.00	Lafeuille et al48 (inflated to 2019 costs using Bureau of Labor Statistics data)49
Monitoring costs
Tumor lysis syndrome prophylaxis	$15,686.00	Cho et al53
Full blood count	$8.63	CMS Clinical Diagnostic Laboratory Fee Schedule 2019 (HCPCS 85025 complete blood count with automated differential white blood cells)
Lactate dehydrogenase	$6.71	CMS Clinical Diagnostic Laboratory Fee Schedule 2019 (HCPCS 83615 lactate dehydrogenase enzyme)
Chest x-ray	$25.23	CMS Physician Fee Schedule 2019 (CPT 71045)
Bone marrow examination	$72.08	CMS Physician Fee Schedule 2019 (CPT 38221)
Hematologist visit	$51.90	CPT 99213 - office/outpatient visit (same CPT as Chen 20179) - CMS Physician Fee Schedule 2019
Inpatient nonsurgical/medical visit	$690.10	Wang et al.50 Hospitalization costs. Inflated from 2019 to 2019 using CPI
Full blood transfusion	$494.08	CMS OPPS Cost Statistics File 2019: Whole blood for transfusion cost (HCPCS P9010) + CMS Physician Fee Schedule 2019 (CPT 36430)
Lymphocyte count	$2.82	CMS Clinical Diagnostic Laboratory Fee Schedule 2019 (HCPCS 85048 automated leukocyte count)
CT scan	$199.30	CMS Physician Fee Schedule 2019 (CPT 71260)
Biochemistry test: renal - urea and electrolytes test	$11.74	CMS Clinical Diagnostic Laboratory Fee Schedule 2019 (HCPCS 80053 comprehensive metabolic panel)
Biochemistry test: liver function test	$9.08	CMS Clinical Diagnostic Laboratory Fee Schedule 2019 (HCPCS 80076 hepatic function panel)
Immunoglobulins blood test	$13.84	CMS Clinical Diagnostic Laboratory Fee Schedule 2019 (HCPCS 86023 comprehensive metabolic panel)
Drug costs (pack size)	Cost per pack
Venetoclax (120 × 100 mg tablets)	$12,293.47	NDC: 00074-0579-28, RED BOOK, last accessed January 28, 2020
Obinutuzumab (25 mg/mL, 40 mL)	$6,649.27	NDC: 00074-0579-28, RED BOOK, last accessed January 28, 2020
Chlorambucil (25 × 2 mg tablets)	$608.19	NDC: 00074-0579-28, RED BOOK, last accessed January 28, 2020
Rituximab IV (10 mg/mL, 10 mL)	$939.52	NDC: 00074-0579-28, RED BOOK, last accessed January 28, 2020
Bendamustine IV (25 mg/mL, 4 mL)	$2,473.80	NDC: 00074-0579-28, RED BOOK, last accessed January 28, 2020
Ibrutinib (28 × 420 mg tablets)	$12,966.10	NDC: 00074-0579-28, RED BOOK, last accessed January 28, 2020
Acalabrutinib (60 × 100 mg tablets)	$14,064.00	NDC: 00074-0579-28, RED BOOK, last accessed January 28, 2020
Subsequent treatment drug acquisition cost
VenG	$104,477.63	Subsequent treatment costs determined by: Subsequent treatment mix, derived from US clinical expert opinion (Ven+R, Ibr, and Ven monotherapy, relative proportion of patients receiving each dependent upon initial treatment). Time point for start of next treatment, derived from the TTNT curves for the VenG and GClb arms from the CLL14 trial. Time on treatment derived from published data: Ven + R,41,54 validated by clinical expert; Ibrutinib,42 validated by clinical expert; Ven monotherapy43
GClb	$467,032.63
BR	$467,032.63
Ibr	$211,212.97
Ibr+G	$211,212.97
Ibr+R	$211,212.97
Acala	$112,737.90
Acala + G	$25,861.77
AE costs
Asthenia	$4,810.18	Borker44
Diarrhea	$5,172.65	Barnes et al45
Dyspnea	$11,903.85	Wong et al47
Febrile neutropenia	$13,545.98	AHRQ46
Infusion-related reaction	$7,289.00	AHRQ46
Leukopenia	$6,911.00	AHRQ46
Neutropenia	$13,565.69	AHRQ46
Pneumonia	$9,046.00	AHRQ46
Sepsis	$17,661.00	AHRQ46
Thrombocytopenia	$10,017.00	AHRQ46
AE disutilities
Asthenia	0.115	NICE TA30634
Diarrhea	0.080	NICE TA21635
Dyspnea	0.103	NICE TA30634
Febrile neutropenia	0.150	NICE TA34333
Infusion-related reaction	0.200	NICE TA34333
Leukopenia	0.090	Assumed same as neutropenia
Neutropenia	0.090	NICE TA34333 Nafees et al36
Pneumonia	0.195	Tolley et al37
Sepsis	0.195	Tolley et al37
Thrombocytopenia	0.108	Tolley et al37

Acala = acalabrutinib; AE = adverse event; AHRQ = Agency for Healthcare Research and Quality; B = bendamustine; Clb = chlorambucil; CMS = Centers for Medicare & Medicaid Services; CPI = Consumer Price Index; CPT = Current Procedural Terminology; CT = computed tomography; G = obinutuzumab; GClb = obinutuzumab plus chlorambucil; HCPCS = Healthcare Common Procedure Coding System; Ibr = ibrutinib; IV = intravenous; NDC = National Drug Code; NICE = National Institute for Health and Care Excellence; R = rituximab; TTNT = time to next treatment; Ven = venetoclax.