Health care resource utilization in 3L + patients with chronic phase chronic myeloid leukemia receiving asciminib or bosutinib

Abstract

Objectives

To assess and compare health care resource utilization (HCRU) rates of asciminib and bosutinib at the Week 24, Week 48, and Week 96 cutoffs among 3 L + patients with chronic myeloid leukemia in chronic phase (CML-CP) in the randomized ASCEMBL trial.

Methods

Patients in the ASCEMBL trial (Clinicaltrials.gov: NCT03106779) were randomized to receive asciminib 40 mg twice daily (n = 157) or bosutinib 500 mg once daily (n = 76). At each scheduled visit, investigators conducted HCRU assessment on hospitalization, emergency room visit, general practitioner visit, specialist visit and urgent care visit; duration and type of hospitalization for the hospitalized patients; and reasons for HCRU. The number of patients with HCRU, rate of HCRU per patient-year, and length of hospital stay by ward type were compared at Week 24, Week 48, and Week 96 analyses.

Results

Lower proportions of patients receiving asciminib versus bosutinib used any resources including hospitalizations, emergency room visits, general practitioner visits, specialist visits, and urgent care visits (23.6% versus 36.8%, 26.1% versus 39.5%, and 28.6% versus 42.6% at Week 24, Week 48, and Week 96 analyses, respectively). After normalizing for treatment exposure, rates of HCRU for any resource per patient-year were significantly lower for asciminib versus bosutinib: 0.25 (95% CI: 0.18–0.34) versus 0.80 (95% CI: 0.55–1.16) at the Week 24 analysis, 0.20 (95% CI: 0.15–0.27) versus 0.47 (95% CI: 0.32–0.66) at the Week 48 analysis, and 0.17 (95% CI: 0.12–0.22) versus 0.40 (95% CI: 0.27–0.55) at the Week 96 analysis. Among the hospitalized patients, mean length of hospital stay was lower for asciminib than bosutinib for most wards at all three timepoints.

Conclusions

In the ASCEMBL trial, asciminib-treated patients with CML-CP in 3 L + maintained lower resource utilization compared to bosutinib over the long-term.

Keywords:

• Asciminib
• bosutinib
• resource use
• economic burden
• chronic myeloid leukemia

JEL CLASSIFICATION CODES:

• I12
• I19

Declaration of financial/other relationships

JEC is a consultant for Novartis, Pfizer, Takeda and Sun Pharma; his institution received research support from BMS, Novartis, Pfizer, Takeda and Sun Pharma. DR received honoraria and/or advisory board payments from Incyte, Novartis and Pfizer. MJM is a consultant for Novartis, BMS, Takeda and Pfizer; his institution received research support from Novartis, BMS, Sun Pharma/SPARC. DT and PW are employees of EVERSANA, Inc who were paid consultants to Novartis. KJ and AY are employees of Novartis and hold stock with Novartis. KS received research funding and advisory board payments from Novartis. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

All authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article. KJ and AY were involved in the conception and design of the study. DT and PW were involved in programming and conducting the analyses. JEC, DR, MJM, and KS were involved in reviewing the data, and all authors participated in interpreting the results. All authors critically reviewed the manuscript for intellectual content and approved the final version of the manuscript. All authors had full access to the data in this study and take complete responsibility for the integrity of the data and accuracy of the data analysis.

Acknowledgements

The authors thank Parash Mani Bhandari (EVERSANA) for medical writing assistance, which was funded by Novartis.

Previous presentation

An abstract of this analysis was presented virtually at ISPOR Europe 2022, Vienna, Austria, 6–9 November 2022.

Additional information

Funding

This work was supported by Novartis Services Inc.