ArticleJournal of the National Cancer Institute2016
Cost-effectiveness of Tyrosine Kinase Inhibitor Treatment Strategies for Chronic Myeloid Leukemia in Chronic Phase After Generic Entry of Imatinib in the United States.
Open access · bronzeAbstract readComparative Study
In one paragraph
Article in Journal of the National Cancer Institute, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 3 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
48citing papers in PubMed, 3 pooled it
10.2field-weighted citation impact, top 1% of its field
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
48 citing papers in PubMed, 3 syntheses or guidelines pooled it, 123 citations in OpenAlex.
- Maximizing the Value of Chronic Myeloid Leukemia Management Using Tyrosine Kinase Inhibitors in the USA: Potential Determinants and Consequences of Healthcare Resource Utilization and Costs, with Proposed Optimization Approaches.Clinical drug investigation · 2024Pooled it
- Current evidence on the efficacy and safety of generic imatinib in CML and the impact of generics on health care costs.Blood advances · 2021Pooled it
- Economic Evaluations of Tyrosine Kinase Inhibitors for Patients with Chronic Myeloid Leukemia in Middle- and High-Income Countries: A Systematic Review.Clinical drug investigation · 2018Pooled it
- Silent NK/T cell reactions to dasatinib during sustained deep molecular response before cessation are associated with longer treatment-free remission.Cancer science · 2020Trial
- Dasatinib in Pediatric Patients With Chronic Myeloid Leukemia in Chronic Phase: Results From a Phase II Trial.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2018Trial
- Dasatinib cessation after deep molecular response exceeding 2 years and natural killer cell transition during dasatinib consolidation.Cancer science · 2018Trial
- Economic value of ribociclib in early breast cancer in the United States.Journal of managed care & specialty pharmacy · 2026Article
- From fatal disease to functional cure: 25 years of tyrosine kinase inhibition in chronic myeloid leukemia.Leukemia · 2026Review
- Article
- Financial Impact of Treatment Choice in Chronic Myeloid Leukemia: A Comparison of Later Generation TKIs versus Imatinib from Patient and Payer Perspectives.ClinicoEconomics and outcomes research : CEOR · 2026Article
- Loss in Overall and Quality-Adjusted Life Expectancy for Patients With Chronic-Phase Chronic Myeloid Leukemia.European journal of haematology · 2025Article
- Valuing the Societal Impact of Medicines and Other Health Technologies: A User Guide to Current Best Practices.Forum for health economics & policy · 2024Article
- Cost-effectiveness of tyrosine kinase inhibitor treatment strategies for chronic myeloid leukemia in South Africa.Frontiers in pharmacology · 2024Article
- Comparable efficacy and safety of generic and branded imatinib for patients with chronic myeloid leukemia in China.Therapeutic advances in hematology · 2024Article
- Inequality in Drug Utilization among Chronic Myeloid Leukaemia Patients in Malaysia: A Cost-Utility Analysis.Asian Pacific journal of cancer prevention : APJCP · 2022Article
- Imatinib Optimized Therapy Improves Major Molecular Response Rates in Patients with Chronic Myeloid Leukemia.Pharmaceutics · 2022Article
- Hybrids of Imatinib with Quinoline: Synthesis, Antimyeloproliferative Activity Evaluation, and Molecular Docking.Pharmaceuticals (Basel, Switzerland) · 2022Article
- Case report: Pleural effusion during tyrosine-kinase inhibitor treatment in chronic myeloid leukemia: Not only a dasatinib-related adverse event.Frontiers in oncology · 2022Article
- Economics influences therapy decisions in chronic myeloid leukaemia: should it?Journal of cancer research and clinical oncology · 2021Article
- Review
Corrections and comments
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Authors and funding
20 authors at 3 institutions in 2 countries.
William V PadulaAffiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
Richard A LarsonAffiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
Stacie B DusetzinaAffiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
Jane F ApperleyAffiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
Rudiger HehlmannAffiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
Michele BaccaraniAffiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
Ekkehard EigendorffAffiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
Joelle GuilhotAffiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
Francois GuilhotAffiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
Rudiger HehlmannAffiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
Francois-Xavier MahonAffiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
Giovanni MartinelliAffiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
Jiri MayerAffiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
Martin C MüllerAffiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
Dietger NiederwieserAffiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
Susanne SausseleAffiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
Charles A SchifferAffiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
Richard T SilverAffiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
Bengt SimonssonAffiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
Rena M ContiAffiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
Heidelberg University · DEDepartment of Health · ZAUniversity Hospital Heidelberg · DE
Funding
Re-Entry Supplement: Investigation of Oral Microbial Enzymes for the Detection and Treatment of Periodontal DiseaseUL1TR002489 · NCATS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI BUSE, JOHN BERNARD, SHAHEEN, NICHOLAS J · 2018 to 2022
$48.6MNorth Carolina Translational & Clinical Sciences Institute (NC TraCS)UL1TR001111 · NCATS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI BUSE, JOHN BERNARD, CAREY, TIMOTHY S · 2013 to 2017
$43.9MUNC BIRCWH CAREER DEVELOPMENT PROGRAMK12HD001441 · NICHD · UNIV OF NORTH CAROLINA CHAPEL HILL · PI BOGGESS, KIM A · 2000 to 2019
$9.3MOncology R&D: Expanding the Role of Economics to Aid Public PolicyK07CA138906 · NCI · UNIVERSITY OF CHICAGO · PI CONTI, RENA MARIE · 2009 to 2013
$672kNCATS NIH HHS UL1 TR001111NCATS NIH HHS UL1TR001111NCATS NIH HHS UL1 TR002489NCI NIH HHS K07-CA138906NICHD NIH HHS K12 HD001441
Abstract
backgroundWe analyzed the cost-effectiveness of treating incident chronic myeloid leukemia in chronic phase (CML-CP) with generic imatinib when it becomes available in United States in 2016. In the year following generic entry, imatinib's price is expected to drop 70% to 90%. We hypothesized that initiating treatment with generic imatinib in these patients and then switching to the other tyrosine-kinase inhibitors (TKIs), dasatinib or nilotinib, because of intolerance or lack of effectiveness ("imatinib-first") would be cost-effective compared with the current standard of care: "physicians' choice" of initiating treatment with any one of the three TKIs.
methodsWe constructed Markov models to compare the five-year cost-effectiveness of imatinib-first vs physician's choice from a US commercial payer perspective, assuming 3% annual discounting ($US 2013). The models' clinical endpoint was five-year overall survival taken from a systematic review of clinical trial results. Per-person spending on incident CML-CP treatment overall care components was estimated using Truven's MarketScan claims data. The main outcome of the models was cost per quality-adjusted life-year (QALY). We interpreted outcomes based on a willingness-to-pay threshold of $100 000/QALY. A panel of European LeukemiaNet experts oversaw the study's conduct.
resultsBoth strategies met the threshold. Imatinib-first ($277 401, 3.87 QALYs) offered patients a 0.10 decrement in QALYs at a savings of $88 343 over five years to payers compared with physician's choice ($365 744, 3.97 QALYs). The imatinib-first incremental cost-effectiveness ratio was approximately $883 730/QALY. The results were robust to multiple sensitivity analyses.
conclusionWhen imatinib loses patent protection and its price declines, its use will be the cost-effective initial treatment strategy for CML-CP.
Indexed as
Drugs, GenericPractice Patterns, Physicians'AdultAgedAntineoplastic AgentsCost-Benefit AnalysisFemaleHumansImatinib MesylateLeukemia, Myelogenous, Chronic, BCR-ABL PositiveMaleMarkov ChainsMiddle AgedModels, EconometricProtein Kinase InhibitorsProtein-Tyrosine KinasesAntineoplastic AgentsDrugs, GenericImatinib MesylateProtein Kinase InhibitorsProtein-Tyrosine Kinases
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.