Will Newer TKIs Change the Economic Landscape?
February 2012 Vol 5, No 1, Special Issue - Health Economics, Health Economics
Neil Canavan
Medical Writer
Neil Canavan
Medical Writer

Few analyses to date have as­sessed the long-term costs associated with the management of chronic myeloid leukemia (CML). At ASH 2011, Shrividya Iyer, PhD, of Pfizer, presented results of a retrospective analysis performed by a group of researchers at Pfizer and the Eliassen Group that looked at information from the Thomson Reuters MarketScan Commercial Claims and Encounters Database, and the Medicare Supple­mental Database. Medical claims for the years 2002-2009 were used for 2583 patients with CML who had ≥2 claims associated with a CML diagnosis.

Costs for the entire CML cohort were analyzed first, followed by a subanalysis of costs related to patients with ≥4 years of postdiagnosis follow-up. The average follow-up for the entire cohort of 2583 patients was 2.7 years, with 509 (20%) patients having ≥4 years of follow-up (mean age, 59 years). More than 50% of the patients had a point-of-service health plan with capitation coverage.  

The proportion of patients with ≥1 CML-related outpatient, inpatient, or emergency department visit annually were:

  • 94.9% for outpatient visits (55.1 actual outpatient and office visits combined, per patient-year)
  • 32.4% for inpatient visits (1.3 average number of actual visits)
  • 15.1% for emergency department visits (1.6 visits).

The average number of drug prescriptions for the entire CML cohort was 6.7 annually, with the tyrosine kinase inhibitor (TKI) imatinib ac­counting for 85% of those claims.

The average annual costs for CML-related healthcare utilization per patient were:

  • $24,391 for outpatient care
  • $24,462 for inpatient care
  • $15,588 for prescription drugs (CML drugs accounted for 73% of overall prescription costs).

Data for patients with ≥4 years of follow-up indicated an increase in outpatient visits, but with nearly equivalent rates for inpatient and emergency department care; for patients with ≥1 CML-related visit, 98% had an outpatient visit, 31% had inpatient care, and 15% had presented to the emergency department on an annual basis.

This analysis did not address the potential cost and utilization impact of the newer TKIs; improved efficacy and reduced side effects may have a positive impact on overall healthcare utilization and costs in the long-term management of CML, but this remains to be seen.
 

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Last modified: March 16, 2012
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