Evidence map›Paper›PMID 38109114›Full record

ArticleJAMA network open2023

Estimated Savings After Stopping Tyrosine Kinase Inhibitor Treatment Among Patients With Chronic Myeloid Leukemia.

Aaron N Winn, Ehab Atallah, Jorge Cortes, Michael W N Deininger, Vamsi Kota, Richard A Larson, Joseph O Moore, Michael J Mauro, Vivian G Oehler, Javier Pinilla-Ibarz and 4 more

Open access · goldAbstract read
In one paragraph

Article in JAMA network open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
2.3field-weighted citation impact, top 10% of its field
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

5 citing papers in PubMed, 8 citations in OpenAlex.

  1. Review
  2. Review
  3. Article
  4. Improving the Dosing Schedules of Targeted Anticancer Agents.Pharmaceuticals (Basel, Switzerland) · 2025
    Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 10 institutions in 1 country.

Aaron N WinnDepartment of Health Systems, Outcomes and Policy, School of Pharmacy, University of Illinois at Chicago.
Ehab AtallahDepartment of Medicine, Medical College of Wisconsin, Milwaukee.
Jorge CortesGeorgia Cancer Center, Augusta University Medical Center, Augusta.
Michael W N DeiningerDepartment of Medicine, Medical College of Wisconsin, Milwaukee.
Vamsi KotaGeorgia Cancer Center, Augusta University Medical Center, Augusta.
Richard A LarsonDepartment of Medicine and Comprehensive Cancer Center, University of Chicago, Chicago, Illinois.
Joseph O MooreDuke University School of Medicine, Durham, North Carolina.
Michael J MauroMemorial Sloan Kettering Cancer Center, New York, New York.
Vivian G OehlerFred Hutchinson Cancer Research Center, Seattle, Washington.
Javier Pinilla-IbarzH. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida.
Jerald P RadichFred Hutchinson Cancer Research Center, Seattle, Washington.
Neil P ShahDepartment of Medicine, University of California at San Francisco.
James E ThompsonRoswell Park Comprehensive Cancer Center, Buffalo, New York.
Kathryn E FlynnDepartment of Medicine, Medical College of Wisconsin, Milwaukee.
Medical College of Wisconsin · USAugusta University Health · USFred Hutch Cancer Center · USDuke University · USMemorial Sloan Kettering Cancer Center · USMoffitt Cancer Center · USRoswell Park Comprehensive Cancer Center · USUniversity of California, San Francisco · USUniversity of Chicago · USUniversity of Illinois Chicago · US

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI SELWYN M VICKERS · 1985 to 2026
$347.4M
Stopping Tyrosine Kinase Inhibitors in CML Patients (Stop-TKIs)R01CA184798 · NCI · MEDICAL COLLEGE OF WISCONSIN · PI ATALLAH, EHAB L, FLYNN, KATHRYN E · 2014 to 2019
$3.3M
NCI NIH HHS P30 CA008748NCI NIH HHS R01 CA184798
6 · The paper itself

Abstract

Importance: Patients with chronic myeloid leukemia (CML) who have a sustained deep molecular response using tyrosine kinase inhibitors (TKIs) can safely attempt to stop their use. As these medications are very costly, this change in treatment protocols may result in large savings. Objective: To estimate future savings from attempting to stop TKI use among patients with CML who have deep molecular response. Design, Setting, and Participants: A microsimulation model was developed for this decision analytical modeling study to estimate costs for US adults moving from using a TKI, to attempting discontinuation and then reinitiating TKI therapy, if clinically appropriate. Estimates were calculated for US patients who currently have CML and simulated newly diagnosed cohorts of patients over the next 30 years. Exposure: Attempting to stop using a TKI. Main Outcomes and Measures: Estimated savings after attempted discontinuation of TKI use. Results: A simulated population of individuals with CML in 2018 and future populations were created using estimates from the SEER*Explorer website. The median age at diagnosis was 66 years for men and 65 years for women. Between 2022 and 2052, the savings associated with eligible patients attempting discontinuation of TKI therapy was estimated at more than $30 billion among those currently diagnosed and over $15 billion among those who will develop CML in the future, for a total savings of over $54 billion by 2052 for drug treatment and polymerase chain reaction testing. The estimate is conservative as it does not account for complications and other health care-associated costs for patients continuing TKI therapy. Conclusions and Relevance: The findings of this decision analytical modeling study of patients with CML suggest that attempting discontinuation of TKI therapy could save over $54 billion during the next 30 years. Further education for patients and physicians is needed to safely increase the number of patients who can successfully attain treatment-free remission.

Indexed as

Leukemia, Myelogenous, Chronic, BCR-ABL PositiveTyrosine Kinase InhibitorsAdultFemaleHealth Care CostsHumansIncomeMalePatientsProtein Kinase InhibitorsProtein Kinase InhibitorsTyrosine Kinase Inhibitors

Identifiers

PMID38109114
PMCPMC10728762
OpenAlexW4389899813

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.