Treatment patterns and healthcare costs among newly-diagnosed patients with chronic myeloid leukemia receiving dasatinib or nilotinib as first-line therapy in the United States

Figures & data

Figure 1. Study design. CML, chronic myeloid leukemia; TKI, tyrosine-kinase inhibitor; HSCT, hematopoietic stem cell transplant; ESRD, end stage renal disease; Tx, treatment; Q1, first quarter; Q4, fourth quarter.

Table 1. Patient characteristics of the dasatinib and nilotinib cohorts.

	Dasatinib	Nilotinib	p-value
	(n = 604)	(n = 418)
At the index date
Patient demographics
Age, years; mean (SD)	50.9 (13.5)	52.5 (12.9)	.114
65+ years old, n (%)	68 (11.3)	60 (14.4)	.142
Female, n (%)	280 (46.4)	191 (45.7)	.834
Region of residence, n (%)
South	204 (33.8)	157 (37.6)	.213
Northeast	129 (21.4)	74 (17.7)	.150
West	114 (18.9)	48 (11.5)	.001*
North central	67 (11.1)	55 (13.2)	.317
Midwest	76 (12.6)	72 (17.2)	.038*
Unknown	14 (2.3)	12 (2.9)	.581
Health plan type, with a prevalence ≥5%, n (%)
PPO	358 (59.3)	262 (62.7)	.273
HMO	76 (12.6)	30 (7.2)	.005*
POS	44 (7.3)	23 (5.5)	.210
Study period duration, months; mean (SD)	17.2 (11.8)	17.9 (12.2)	.380
≥6 months, n (%)	481 (79.6)	333 (79.7)	.991
≥12 months, n (%)	343 (56.8)	249 (59.6)	.376
≥24 months, n (%)	157 (26.0)	125 (29.9)	.169
Initial daily dose
Initiated on a lower daily dose than recommended, n (%)	17 (2.8)	34 (8.1)	.001*
Initiated on the recommended daily dose, n (%)	551 (91.2)	318 (76.1)	.001*
Initiated on a higher daily dose than recommended, n (%)	36 (6.0)	66 (15.8)	.001*
During the baseline
Darkow disease complexity index, n (%)
Mild	280 (46.4)	180 (43.1)	.298
Moderate	204 (33.8)	149 (35.6)	.536
Severe	120 (19.9)	89 (21.3)	.579
CCI excluding CML, mean (SD)	1.4 (1.4)	1.5 (1.5)	.600
CCI >1, n (%)	290 (48.0)	199 (47.6)	.427
CCI >2, n (%)	112 (18.5)	91 (21.8)	.204
CCI >3, n (%)	33 (5.5)	37 (8.9)	.035*
Comorbidities with a prevalence ≥5%, n (%)
Hypertension	227 (37.6)	146 (34.9)	.386
Anemia	201 (33.3)	142 (34.0)	.818
Hyperlipidemia	220 (36.4)	141 (33.7)	.376
Diabetes	94 (15.6)	67 (16.0)	.841
Cardiovascular disease	62 (10.3)	52 (12.4)	.277
Fluid electrolyte disorders	61 (10.1)	47 (11.2)	.558
Coagulopathy	53 (8.8)	44 (10.5)	.348
Hypothyroidism	64 (10.6)	40 (9.6)	.594
Chronic pulmonary disease	49 (8.1)	40 (9.6)	.417
Obesity	40 (6.6)	27 (6.5)	.917
Weight loss	42 (7.0)	24 (5.7)	.438
Fibromyalgia	33 (5.5)	21 (5.0)	.757
Depression	38 (6.3)	17 (4.1)	.121

n, number; SD, standard deviation; CML, chronic myeloid leukemia; PPO, preferred provider organization; HMO, health maintenance organization; POS, point of service; CCI, Charlson comorbidity index.

* Significant at the 5% level.

Figure 2. Estimated rates of dose decrease for the dasatinib and nilotinib cohorts. KM, Kaplan–Meier; CI, confidence interval.

Figure 3. Adjusted comparison of treatment patterns and HRU between the dasatinib and nilotinib cohorts HR, hazard ratio; CI, confidence interval; HRU, health resource utilization; IRR, incidence rate ratio; IP, inpatient; ER, emergency room; OP, outpatient. * Significant at the 5% level.

Figure 4. Rates of treatment switch for the dasatinib and nilotinib cohorts. KM, Kaplan-Meier; CI, confidence interval.

Figure 5. Comparison of healthcare costs between the dasatinib and nilotinib cohorts. PPPM, per patient per month; TKI, tyrosine kinase inhibitor; IP, inpatient; ER, emergency room; OP, outpatient; USD, United States dollars. * Significant at the 5% level.