Cost-Effectiveness Analysis of Asciminib in Patients With Chronic Phase Chronic Myeloid Leukemia Previously Treated With 2 or More Tyrosine Kinase Inhibitors in Colombia.

OBJECTIVES

To assess the cost-effectiveness of asciminib in adult patients with chronic-phase chronic myeloid leukemia who have been treated with 2 or more tyrosine kinase inhibitors, from a third-party payer perspective in Colombia.

METHODS

A nonhomogeneous partitioned survival model was developed using ASCEMBL trial and matching-adjusted indirect comparisons. Outcomes included overall survival, progression-free survival, and safety. Overall survival was modeled using exponential functions based on 6-month major molecular response rates. Quality-adjusted life-years (QALYs) were estimated using phase-specific utilities. Direct medical costs were obtained from national public databases (2024-2025) and expressed in 2025 USD (USD 1 = COP 4053). A 30-year time horizon was applied. Base case compared asciminib with bosutinib and ponatinib. Scenario analyses included nilotinib and dasatinib because they are rarely used in third line in Colombia. Sensitivity analyses explored ponatinib dose deescalation, generic drug pricing, asciminib price thresholds, relative dose intensity, and alternative overall survival assumptions. Probabilistic sensitivity analyses were performed.

RESULTS

Asciminib was dominant compared with bosutinib and ponatinib, yielding more QALYs (0.41 and 0.20) and lower costs (-USD 47 334 and -USD 88 554). Scenario analyses including nilotinib and dasatinib favored asciminib, with higher QALYs (0.32 and 0.25) and lower costs (-USD 43 785 and -USD 6400). Results remained robust across analyses, including ponatinib dose deescalation, generic pricing, relative dose intensity, and alternative overall survival assumptions.

CONCLUSIONS

Asciminib was a dominant treatment option for patients with chronic-phase chronic myeloid leukemia who have been treated with 2 or more tyrosine kinase inhibitors, offering clinical and economic advantages over other pharmacological treatments.