ArticleBMC health services research2026
Organizational impacts of fixed-duration therapies for the management of patients with chronic lymphocytic leukemia in Italy.
Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundChronic Lymphocytic Leukemia (CLL) is a common adult leukemia characterized by the progressive accumulation of dysfunctional lymphocytes. Recently introduced fixed-duration targeted therapies for previously untreated patients have demonstrated superior efficacy compared to chemotherapy, while offering time-limited treatment that improves patient quality of life and reduces the burden on healthcare systems compared to continuous therapies. This analysis examines the organizational impact of implementing first-line, fixed-duration CLL therapies, with focus on healthcare resource allocation, costs, and patient management.
methodsThe regimens analyzed included ibrutinib + venetoclax (I + V, oral), venetoclax + obinutuzumab (Ven-Obi, oral/infusion), bendamustine + rituximab (BR, infusion), chlorambucil + obinutuzumab (Clb-Obi, oral/infusion), and fludarabine + cyclophosphamide + rituximab (FCR, infusion). Data were defined through product characteristics, published literature, expert opinion, and standard hospital procedures for drug administration, adverse event management, and treatment duration. A questionnaire administered in four Italian centers captured organizational aspects such as healthcare personnel time, patient assessment, treatment preparation and administration, and follow-up.
resultsPersonnel time and costs varied substantially across regimens, with administration mode (oral vs. infusion) emerging as a key driver. Time ranged from 4,899 min (81.6 h) for BR to 8,019 min (133.7 h) for Ven-Obi. Organizational costs ranged from €3,942 (BR) to €8,631 (Ven-Obi). The all-oral I + V combination showed a lower cost profile (€5,724) than Ven-Obi and was comparable to Clb-Obi, despite additional monitoring requirements.
conclusionsTreatment selection should balance efficacy with organizational and economic considerations. Findings highlight that oral therapies improve efficiency and patient convenience while reducing delivery costs.
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