Chronic Myeloid Leukemia Coverage from Every Angle
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Medication Adherence and Cost for Patients With CML

By: Lauren Harrison, MS
Posted: Monday, April 8, 2019

Patient adherence to treatment with tyrosine kinase inhibitors (TKI) for chronic myeloid leukemia (CML) has increased over time. In addition, imatinib remains the most frequently used TKI, but second-generation agents are becoming increasingly popular. Eric  J. Chow, MD, MPH, of Fred Hutchinson Cancer Research Center, Seattle, and colleagues presented their findings at the 2019 National Comprehensive Cancer Network (NCCN) Annual Conference (Abstract HSR19-090).

“Possible cost-offsets are decreasing over time, but it may be too early to formally evaluate the impact of generic imatinib,” the authors concluded.

A total of 1,793 patients with CML were identified from the OptumLabs Data Warehouse; they initiated TKI treatment between May 2001 and October 2016. Both privately insured and Medicare Advantage patients were included in the study.

During this period, the adherence to treatment increased. The medication possession ratio (MPR1) was used to quantify adherence. A score of 1 indicated perfect adherence. Men had higher MPR1 values than women, and MPR1 increased with age until age 62, where a decline was seen. Those with comorbid conditions prior to treatment had lower rates of treatment adherence.

In addition, MPR1 was inversely associated with total health-care costs among those with private insurance, but not among those utilizing Medicare Advantage. The impact of MPR1 on health-care costs, both medical and pharmaceutical, diminished over time. A 10% decrease in MPR1 was associated with 12% lower health-care costs before the availability of second-generation TKIs and a 4% decrease in costs after the availability of second-generation TKIs. When medical costs alone are considered, MPR1 was inversely associated with medical costs for both privately insured and Medicare Advantage enrollees.

Disclosure: The study authors reported no conflicts of interest.



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