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- Title
CML-311: Healthcare Resource Utilization and Associated Costs Among Patients with Chronic Myeloid Leukemia by Line of Therapy in the United States (US) from a Commercial Perspective.
- Authors
Atallah, Ehab; Maegawa, Rodrigo; Latremouille-Viau, Dominick; Rossi, Carmine; Guérin, Annie; Patwardhan, Pallavi
- Abstract
Despite advances in therapy, many patients with chronic myeloid leukemia in chronic phase (CML-CP) are refractory or intolerant to tyrosine kinase inhibitors (TKIs). To assess treatment patterns and economic outcomes among commercially insured patients with CML by line of TKI therapy (LOT). Adult patients with CML in the US who received ≥1 LOT were identified in the IBM MarketScan Commercial and Medicare Supplement databases (01/01/2001–06/30/2019). Treatment patterns, and all-cause and CML-related healthcare resource utilization (HRU: inpatient [IP] days, days with outpatient [OP] visits, and emergency department [ED] visits) and healthcare costs (medical+pharmacy) were measured by LOT; sensitivity analysis was performed after generic imatinib availability (02/01/2016). HRU was reported using annual incidence rates (IR), and costs (2019 USD, payer's perspective) were reported per-patient-per-month (PPPM). Costs were stratified for hematopoietic stem cell transplantation (HSCT) status during LOT. From 2001 to 2019, first-generation (1G) TKI (i.e., imatinib) was most prevalent in first-line (1L [N=3,234]; 66.2%), and second-generation (2G) TKIs (i.e., nilotinib, dasatinib, bosutinib) were most prevalent in second-line (2L [N=954]; 83.9%), third-line (3L [N=296]; 74.7%), and fourth-line (4L [N=83]; 69.9%). After 02/01/2016, 2G TKIs were most prevalent in 1L ([N=440]; 57.7%), 2L ([N=208]; 72.6%), 3L ([N=90]; 77.8%), and 4L ([N=29]; 69.0%). Annual IR increased between 1L and 4L: 1.3 to 2.4 for IP days, 23.1 to 31.6 for OP visits, and 0.6 to 0.8 for ED visits. The proportion of CML-related IP days increased from 69% to 80% between 1L and 4L. Mean all-cause costs increased between 1L and 4L from $10,340 (25% from medical) to $19,546 PPPM (47% from medical), with approximately 90% of costs CML-related. Excluding HSCT, mean all-cause costs increased from $10,322 (25% from medical) to $15,073 PPPM (31% from medical). After 02/01/2016, all-cause costs increased between 1L and 4L from $13,312 (21% from medical) to $18,379 PPPM (36% from medical). Excluding HSCT, mean all-cause costs increased from $13,275 (21% from medical) to $18,092 PPPM (35% from medical). Commercially insured patients with CML had increasing HRU and costs as they cycled through TKIs, highlighting the need for new treatments that can help optimize disease management. Novartis
- Publication
Clinical Lymphoma, Myeloma & Leukemia, 2021, Vol 21, pS333
- ISSN
2152-2650
- Publication type
Article
- DOI
10.1016/S2152-2650(21)01780-8