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<h3>Background and Importance</h3> Although ibrutinib (IBR) is effective across all treatment lines for chronic lymphocytic leukaemia (CLL), its use is frequently limited by adverse events leading to discontinuation or dose reduction. Evidence suggests that lowering the dose may preserve efficacy while improving tolerability. <h3>Aim and Objectives</h3> To describe the real-world experience of CLL patients treated with reduced doses of IBR in a primary care hospital. Calculate the economic savings derived from this dose reduction. <h3>Material and Methods</h3> A retrospective observational study was conducted including CLL patients treated with IBR who required dose reduction below 420 mg/day due to toxicity, interactions, or physician decision once disease control was achieved. All patients who received ibrutinib at our centre since we have records, in 2016, were recruited. We obtained information from the pharmaceutical care program and from the medical history. The economic calculation was made based on the cost of each container at the time of purchase, taking into account price changes. <h3>Results</h3> Seventy patients were included, with a median age of 73 years (IQR 29–88). The IBR dose was reduced in 56 patients (80%), mainly due to physician decision (50%), toxicity (43%), or interactions (7%). Patients who maintained the full dose had received more prior treatment lines and more often presented TP53 mutations. Median progression-free survival (PFS) was 4.7 years (95% CI: 3.1–6), and median time to next treatment (TTNT) was 5.7 years (95% CI: 4.0–not reached). In patients with dose reductions, median PFS was 5.3 years (95% CI: 3.8–6.6), with no statistically significant difference versus those without reductions (p=0.0594). Estimated annual cost savings were 687,040€. <h3>Conclusion and Relevance</h3> IBR dose reduction in CLL patients appears to maintain clinical efficacy while improving tolerability and reducing costs. Further studies with larger samples and refined methodology are warranted to confirm these findings and assess new therapeutic strategies such as IBR–venetoclax combinations. <h3>Conflict of Interest</h3> No conflict of interest