Zanubrutinib (Brukinsa)

Abstract

CADTH recommends that Brukinsa be reimbursed by public drug plans for the treatment of adult patients with chronic lymphocytic leukemia (CLL) if certain conditions are met. Brukinsa should only be covered to treat adult patients with previously untreated CLL for whom fludarabine-based treatment is inappropriate or patients with relapsed or refractory (r/r) CLL who have received at least 1 prior systemic therapy. Patients receiving Brukinsa should be in relatively good health (i.e., have a good performance status, as determined by a specialist). Patients who have progressed on a Bruton tyrosine kinase (BTK) inhibitor or patients with prolymphocytic leukemia or Richter’s transformation should not be eligible for coverage. Brukinsa should only be reimbursed if prescribed by clinicians with expertise and experience in the treatment of CLL and monitoring of therapy and if it is associated with cost savings for drug programs relative to ibrutinib or acalabrutinib. Patients who experience disease progression while taking Brukinsa or who cannot tolerate the drug would not be eligible for continued coverage.