Chronic Myeloid Leukemia Coverage from Every Angle

TKI Initiation and Health-Care Costs for Patients With CML

By: Cordi Craig
Posted: Wednesday, October 30, 2019

Hsiao Ling Phuar, PhD, BPharm, and colleagues at The University of Texas Health Science Center, Houston, reported that patients with newly diagnosed chronic myeloid leukemia (CML) who receive earlier access to tyrosine kinase inhibitor (TKI) treatment may be at a lower risk of hospitalizations, which may reduce overall health-care costs in the first year of treatment. The results, published in the Journal of Managed Care & Specialty Pharmacy, suggested that lower medical and non-TKI pharmacy costs partially offset the higher TKI initiation costs within the first month of diagnosis.

The study authors retrospectively analyzed the association between cost-sharing and TKI initiation in 477 patients with CML from the IBM MarketScan Commercial Database. Within the patient population, 397 patients (83.2%) initiated TKI treatment within the first month of diagnosis and 80 patients (16.8%), after the first month.

The out-of-pocket costs for the first month of TKI therapy were not a significant predictor of TKI initiation time. Patients who initiated TKI therapy within the first month were significantly less likely to have all-cause hospitalizations (P = .02) or CML-specific hospitalizations (P < .01) compared with patients who began TKI therapy after the first month. Patients who initiated therapy in the first month incurred $9,923 more in TKI pharmacy costs over the 12-month follow-up period. However, patients who initiated therapy after the first month incurred $7,582 more in medical costs, $218 more in non-TKI pharmacy costs, and $2,680 more in total health-care costs.

Disclosure: The study authors reported no conflicts of interest.

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