Bubble diagram of the Markov model. Bubbles indicate health states and arrows indicate possible transitions between states. In each cycle, the cohort can either transition to another health state, die, or remain in the same state. (A) Transition pathways for both VenO and ClbO, and (B) pathways for ibrutinib. After progression, patients were assumed to receive either no treatment, VenR, or ibrutinib as second-line treatment, with the exception that second-line ibrutinib could not be given to patients progressing after first-line ibrutinib. Tunnel states were used for second-line treatment pathways.