The use of tyrosine kinase inhibitors (TKIs) use as a first-line treatment for chronic myelogenous leukemia (CML) among older patients has increased since 2007 (J Manag Care Spec Pharm. 2020;26[12]:1494-1504. doi:10.18553/jmcp.2020.26.12.1494).
“Following approval of imatinib, a breakthrough [TKI], survival significantly improved by more than 20% since 2001 among treated [CML] patients. Subsequently, more expensive second-generation TKIs with varying selectivity profiles have been approved,” explained Donna Rivera, PharmD, MSc, National Cancer Institute, Division of Cancer Control and Population Sciences, Surveillance Research Program, Rockville, Maryland, and colleagues.
“Population-based studies are needed to evaluate the real-world utilization of TKI therapies, particularly given their escalating costs and recommendations for maintenance therapy,” they continued.
This study aimed to assess the utilization patterns of first-line TKIs among elderly CML patients in the US and associated costs.
Patients aged 65 years and older at diagnosis were identified and the percentage of patients receiving specific TKIs within the first year of diagnosis was calculated. The TKIs studied were imatinib, dasatinib, or nilotinib. The average monthly patient costs were also calculated.
Authors found that between 2007 and 2015, receipt of any TKI within 1 year of diagnosis increased from 66.2% to 78.9%. TKI treatment was initiated in 60% of patients within the first 3 months of diagnosis. Out-of-pocket costs were lower for low-income subsidy eligible patients than for low-income subsidy ineligible patients.
“Study findings show an increase in TKI use from 66% in 2007 to 79% in 2015, along with an increased diffusion of newer agents dasatinib and nilotinib; 60% of included CML patients initiated TKI treatment within 3 months of diagnosis,” concluded Dr Rivera and colleagues.—Lisa Kuhns
