Increasing TKI Utilization and Costs for CML Put Pressure on Medicare Part-D Insurers

The increase in use of tyrosine kinase inhibitors (TKIs) for patients with chronic myelogenous leukemia (CML), as well as the increase in TKI drug prices, places considerable financial pressure on Medicare part-D insurers, according to a study published in JCO Oncology Practice (2021;OP2000967. doi:10.1200/OP.20.00967).

“Treatment of CML with TKIs has improved survival but is associated with significant financial burden,” wrote Brian Talon, PharmD, Department of Pharmacy Systems, Outcomes & Policy, University of Illinois at Chicago College of Pharmacy, and colleagues.

This study used SEER linked to Medicare part-D claims data in prevalent CML cases to measure trends in TKI utilization, Medicare gross payment, and patient out-of-pocket expenditure from 2007 to 2016.  

A total of 3189 CML cases were identified with at least 1 TKI claim. The proportion of patients with a TKI fill in a year increased from 17% in 2007 to 52.8% in 2015. The average annual gross payment per 30-day supply of a TKI increased by an average of 12.8% from $9000 to $10,000 in 2016.

Dr Talon and colleagues reported no increasing trend for OOP expenditure per 30-day supply throughout the study period, which varied between $450 to $600.

“Rising TKI use and TKI drug prices place considerable financial pressure on Medicare part-D insurers. Although there was no increasing trend in OOP expenditure, it may be burdensome for Medicare patients who are likely retired on a fixed income,” concluded Dr Talon and colleagues.

“Our findings support legislation that mitigates increasing drug prices to protect the Medicare system and its beneficiaries,” they added.—Janelle Bradley