Evidence map›Paper›PMID 27998234›Full record

ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2016

Factors Associated With Tyrosine Kinase Inhibitor Initiation and Adherence Among Medicare Beneficiaries With Chronic Myeloid Leukemia.

Aaron N Winn, Nancy L Keating, Stacie B Dusetzina

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 72 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
72citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

72 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
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  6. A proactive financial navigation intervention in patients with newly diagnosed gastric and gastroesophageal junction adenocarcinoma.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024
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  15. Quality of Treatment Selection for Medicare Beneficiaries With Cancer.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2025
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12 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors.

Aaron N WinnAaron N. Winn and Stacie B. Dusetzina, University of North Carolina at Chapel Hill, Chapel Hill, NC; and Nancy L. Keating, Harvard Medical School and Brigham and Women's Hospital, Boston, MA.
Nancy L KeatingAaron N. Winn and Stacie B. Dusetzina, University of North Carolina at Chapel Hill, Chapel Hill, NC; and Nancy L. Keating, Harvard Medical School and Brigham and Women's Hospital, Boston, MA.
Stacie B DusetzinaAaron N. Winn and Stacie B. Dusetzina, University of North Carolina at Chapel Hill, Chapel Hill, NC; and Nancy L. Keating, Harvard Medical School and Brigham and Women's Hospital, Boston, MA.

Funding

North 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
$43.9M
Behavioral Economics and Improving Chemotherapy Decisions for Advanced CancerK24CA181510 · NCI · HARVARD MEDICAL SCHOOL · PI KEATING, NANCY L · 2014 to 2018
$867k
NCATS NIH HHS UL1 TR001111NCI NIH HHS K24 CA181510
6 · The paper itself

Abstract

Purpose There is substantial concern surrounding affordability of orally administered anticancer therapies, particularly for Medicare beneficiaries. We examined rates of initiation and adherence to tyrosine kinase inhibitors (TKIs) among Medicare beneficiaries with chronic myeloid leukemia (CML) with and without cost-sharing subsidies. We selected TKIs given their effectiveness and strong indication for use among patients diagnosed with CML. Patients and Methods Using SEER-Medicare data, we identified individuals diagnosed with CML from 2007 to 2011. We used Cox proportional hazards regression to assess time from diagnosis to TKI initiation. We used generalized estimating equations to examine treatment initiation within 180 days and TKI adherence among initiators. We defined adherence as at least 80% of days covered during the 6 months after TKI initiation. Results Among 393 individuals diagnosed with CML from 2007 to 2011, 68% initiated TKI treatment within 180 days after diagnosis. In multivariate analysis, individuals with cost-sharing subsidies, younger age, lower comorbidity, and later year of diagnosis were significantly more likely to initiate TKIs. Among TKI initiators, 61% were adherent; adherence was lower for individuals age 80 years or older versus 66 to 69 years. Conclusion Only 68% of Medicare beneficiaries with CML initiated TKI therapy within 6 months of diagnosis. Delayed initiation among individuals without cost-sharing subsidies suggests that out-of-pocket costs may be a barrier to timely initiation of therapy among individuals diagnosed with CML.

Indexed as

Drug MonitoringAgedAged, 80 and overAntineoplastic AgentsCohort StudiesDose-Response Relationship, DrugDrug Administration ScheduleFemaleHumansLeukemia, Myelogenous, Chronic, BCR-ABL PositiveMaleMedicarePatient CompliancePrognosisProportional Hazards ModelsProtein Kinase InhibitorsAntineoplastic AgentsProtein Kinase InhibitorsProtein-Tyrosine Kinases

Identifiers

PMID27998234
PMCPMC5455309

What OpenQuestion holds

Textmetadata
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Registered trials

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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.