Why A Payer Should Not Step-Edit BTK-inhibitors?
Published Date:
The Evidence is Beyond Clear
Lucio N. Gordan, MD – President & Managing Physician
Florida Cancer Specialists & Research Institute
ZANUBRUTINIB is a potent and selective covalent Bruton’s tyrosine kinase (BTK) inhibitor developed to improve upon earlier-generation BTK inhibitors (e.g., ibrutinib) by achieving higher BTK occupancy, fewer off-target effects, and improved safety/tolerability. In multiple phase III trials (e.g., the ALPINE trial in relapsed/refractory CLL; ASPEN in Waldenström’s; SEQUOIA in treatment-naïve CLL) zanubrutinib has demonstrated either superior efficacy or non-inferior efficacy plus favorable safety versus comparators.
Step-therapy edits that require patients to first fail older therapies create barriers to accessing optimal therapy. The scientific and economic evidence suggests that, for many patients, upfront use of zanubrutinib may yield better outcomes and lower total cost of care.