The American journal of managed care · 2012
Value of survival gains in chronic myeloid leukemia.
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Yin Wesley, Penrod John R, Maclean Ross, Lakdawalla Darius N, Philipson Thomas
Аннотация
UNLABELLED: Although clinical trial data have quantified patient survival gains associated with tyrosine kinase inhibitors in chronic myeloid leukemia, the overall value of these benefits is unknown.
OBJECTIVE: To estimate the total value of survival gains associated with first- and second-line TKI therapy in chronic myeloid leukemia (CML) and the fraction of tyrosine kinase inhibitor (TKI)- related survival-gain value retained by patients and drug companies.
STUDY DESIGN: This retrospective study identified CML patient data from the Surveillance, Epidemiology and End Results registry, dasatinib clinical trials, and insurance claims data sets.
METHODS: Multivariate Cox proportional hazard models were used to estimate improvements in CML survival associated with the introduction of first-line imatinib therapy. Survival gains associated with second-line dasatinib treatment were identified via retrospective analyses and published clinical outcomes. An economic model was developed to calculate the social value of survival gains derived from first- and second-line TKI treatment. TKI costs were used to estimate the fraction of survival gain value retained by patients and drug companies.
RESULTS: The introduction of TKIs in 2001 was associated with a hazard ratio of 0.833 (P <.01). Cost analyses indicate that the TKI drug class in CML therapy has created more than $143 billion in social value. Approximately 90% of this value is retained by patients and society, while approximately 10% is recouped by drug companies.
CONCLUSIONS: These estimates indicate that the introduction of TKI drugs to treat CML has generated significant social value as a result of survival gains, the vast majority of which has accrued to patients.
OBJECTIVE: To estimate the total value of survival gains associated with first- and second-line TKI therapy in chronic myeloid leukemia (CML) and the fraction of tyrosine kinase inhibitor (TKI)- related survival-gain value retained by patients and drug companies.
STUDY DESIGN: This retrospective study identified CML patient data from the Surveillance, Epidemiology and End Results registry, dasatinib clinical trials, and insurance claims data sets.
METHODS: Multivariate Cox proportional hazard models were used to estimate improvements in CML survival associated with the introduction of first-line imatinib therapy. Survival gains associated with second-line dasatinib treatment were identified via retrospective analyses and published clinical outcomes. An economic model was developed to calculate the social value of survival gains derived from first- and second-line TKI treatment. TKI costs were used to estimate the fraction of survival gain value retained by patients and drug companies.
RESULTS: The introduction of TKIs in 2001 was associated with a hazard ratio of 0.833 (P <.01). Cost analyses indicate that the TKI drug class in CML therapy has created more than $143 billion in social value. Approximately 90% of this value is retained by patients and society, while approximately 10% is recouped by drug companies.
CONCLUSIONS: These estimates indicate that the introduction of TKI drugs to treat CML has generated significant social value as a result of survival gains, the vast majority of which has accrued to patients.