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Pharmacoeconomic Considerations for Tyrosine Kinase Inhibitors in the Treatment of Chronic Myeloid Leukemia

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Chronic Myeloid Leukemia

Part of the book series: Hematologic Malignancies ((HEMATOLOGIC))

Abstract

The introduction and use of the tyrosine kinase inhibitor (TKI) drugs have markedly improved the overall survival and quality of life for patients with chronic myeloid leukemia (CML). There are currently five branded TKIs approved in the United States (US) and European Union (EU) for CML treatment, and one generic option (Gleevec’s generic, imatinib). Imatinib, a first-generation TKI, was the first treatment approved for CML by the European Medicines Agency and the Food and Drug Administration in 2001. Second-generation TKIs dasatinib, nilotinib, and bosutinib have since been approved in the US and EU for both patients who are resistant or intolerant to prior therapy (in 2006 and 2007) as well as those with newly diagnosed disease. Ponatinib is a highly active but more toxic third-generation TKI approved in 2012 as a last option or for patients with T315I-mutated CML patients. Internationally, many countries have added CML TKIs to their national formularies; however, despite their clinical benefits for patients, affordability of TKIs remains a significant concern in the US.

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Acknowledgements

Jasmine Johnson, BS. Dominique Seo.

Disclosures

BM received research support from the Hematology/Oncology Pharmacy Association. JN received funding for doctoral studies through a fellowship sponsored by Bristol Myers Squibb. AC is a paid employee and stockholder of GSK. RAL acted as a consultant or advisor to Novartis, Amgen, Ariad/Takeda, Astellas, Celgene/BMS, CVS/Caremark, Epizyme, and MorphoSys and has received clinical research support from Novartis, Astellas, Celgene, Cellectis, Daiichi Sankyo, Forty Seven, Rafael Pharmaceuticals, and royalties from UpToDate. SBD reports grants from the Commonwealth Fund, the Leukemia & Lymphoma Society, Arnold Ventures, and the Robert Wood Johnson Foundation. She also receives honoraria for her participation as an expert advisory panel member for West Health, the Institute for Clinical and Economic Review, and consulting payments from the National Academy of State Health Policy.

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Authors and Affiliations

  1. Division of Pharmacotherapy and Experimental Therapeutics, University of North Carolina Eshelman School of Pharmacy, Chapel Hill, NC, USA

    Benyam Muluneh

  2. Questrom School of Business, Boston University, Boston, MA, USA

    Rena M. Conti

  3. Division of Pharmaceutical Outcomes and Policy, University of North Carolina Eshelman School of Pharmacy, Chapel Hill, NC, USA

    Joehl Nguyen & Ashley Cole

  4. Department of Medicine and the Comprehensive Cancer Center, University of Chicago, Chicago, IL, USA

    Richard A. Larson

  5. Department of Health Policy and Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA

    Stacie B. Dusetzina

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  1. Benyam Muluneh
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  2. Rena M. Conti
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  4. Ashley Cole
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  6. Stacie B. Dusetzina
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Correspondence to Benyam Muluneh .

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    Rüdiger Hehlmann

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Muluneh, B., Conti, R.M., Nguyen, J., Cole, A., Larson, R.A., Dusetzina, S.B. (2021). Pharmacoeconomic Considerations for Tyrosine Kinase Inhibitors in the Treatment of Chronic Myeloid Leukemia. In: Hehlmann, R. (eds) Chronic Myeloid Leukemia. Hematologic Malignancies. Springer, Cham. https://doi.org/10.1007/978-3-030-71913-5_7

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