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Economics influences therapy decisions in chronic myeloid leukaemia: should it?

  • Original Article – Clinical Oncology
  • Published:
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Abstract

The question whether economic considerations should influence therapy decisions in persons with chronic myeloid leukaemia (CML) is complex touching on many metrics other than medicine including the perceptions, attitudes, and motivations of physicians, patients, their families, and payors’, allocation of health care resources, and others. We discuss metrics whereby physicians, patients, and payors make CML therapy choices in settings where cost and availability are or are not considerations. We conclude that economic considerations strongly influence therapy decisions in CML. Whether this should be so and what impact it has on outcomes is also considered. Absent definitive data proving which therapy strategy is best allowing economic considerations to operate may not be as unreasonable or unethical as it appears. In some settings, it may be the best approach. However, because TKIs markedly prolong survival and may even cure some persons with CML, TKI therapy should be available to everyone with CML.

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Acknowledgements

RPG acknowledges support from the National Institute of Health Research (NIHR) Biomedical Research Centre funding scheme.

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Authors and Affiliations

  1. Peking University Peoples Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing, China

    Qian Jiang

  2. University of Chicago Comprehensive Cancer Center, Chicago, IL, USA

    Richard A. Larson

  3. Department of Immunology and Inflammation, Centre for Haematology Research, Imperial College London, London, SW7 2AZ, UK

    Robert Peter Gale

Authors
  1. Qian Jiang
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  2. Richard A. Larson
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  3. Robert Peter Gale
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Correspondence to Robert Peter Gale.

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Conflict of interest

RAL has 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. RPG is a consultant to: BeiGene Ltd., Fusion Pharma LLC, LaJolla NanoMedical Inc., Mingsight Parmaceuticals Inc., and CStone Pharmaceuticals. Medical Director of FFF Enterprises Inc, on the Board of Directors: RakFond Foundation for Cancer Research Support. Scientific Advisory Board: Antegene Biotech LLC, StemRad Ltd.

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Jiang, Q., Larson, R.A. & Gale, R.P. Economics influences therapy decisions in chronic myeloid leukaemia: should it?. J Cancer Res Clin Oncol 147, 3693–3698 (2021). https://doi.org/10.1007/s00432-021-03607-5

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  • DOI: https://doi.org/10.1007/s00432-021-03607-5

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