Healthcare utilization and costs associated with tyrosine kinase inhibitor switching in patients with chronic myeloid leukemia

Abstract

Differences in healthcare utilization and costs were examined in chronic myeloid leukemia (CML) patients experiencing first-, second- and third-line tyrosine kinase inhibitor (TKI) therapy. Three CML cohorts were identified from the Truven Health MarketScan® database: No-Switch Cohort (NSc) = did not switch from first-line; One-Switch Cohort (OSc) = switched from first- to second-line only; Two-Switch Cohort (TSc) = switched to second- and then third-line. A total of 3510 patients were identified (mean = 54%; age = 55.8 years). NSc comprised 81% of the sample, OSc comprised 15% and 4% were in the TSc. First-line utilization/costs were significantly higher in the OSc/TSc compared to the NSc. Second-line hospital/outpatient visits and costs were higher in TSc compared to OSc. TSc experienced a significant cost increase from first- to second-line ($4226.46), twice that of OSc ($2488.03). TKI switching is associated with a substantial increase in healthcare utilization and costs, particularly for patients who switch twice.

Keywords:

• Tyrosine kinase inhibitors
• chronic myeloid leukemia
• treatment failure
• burden
• switching
• healthcare resource utilization
• costs

Acknowledgements

Sponsorship for this study and article processing charges were funded by Teva Pharmaceuticals, Frazer, PA. Editorial assistance in the preparation of this manuscript was provided by Dr Jason Allaire, PhD, of Generativity Solutions Group, Cary, NC. Support for this assistance was funded by Teva Pharmaceuticals. Acknowledgment of Truven Health Analytics for their technical assistance. G.B., A.P. and B.T. are employees of Teva Pharmaceuticals. J.P.I. reports grants and personal fees from Astex, personal fees from GSK, personal fees from Janssen, outside the submitted work. P.K. reports personal fees from Takeda Company, personal fees from Celgene Corporation, outside the submitted work. Gisoo Barnes is now at Novartis Pharmaceuticals.

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article at http://dx.doi.org/10.3109/10428194.2015.1088654