Cost Sharing and Adherence to Tyrosine Kinase Inhibitors for Patients With Chronic Myeloid Leukemia

Dusetzina, Stacie B.; Winn, Aaron N.; Abel, Gregory A.; Huskamp, Haiden A.; Keating, Nancy L.

doi:10.1200/jco.2013.52.9123

Cited by 446 publications

(358 citation statements)

References 28 publications

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“…The adverse influence of co-payments for TKIs had been described before (Kapoor et al 2015;Dusetzina et al 2014) and also in our data we saw that less personal payment obligations and living alone were factors especially increasing the patient's probability to be at least medium adherent which is important as being in the low adherence group will most probably result in treatment failure (Marin et al 2010). …”

Section: Discussionsupporting

confidence: 79%

Factors influencing adherence in CML and ways to improvement: Results of a patient-driven survey of 2546 patients in 63 countries

Geißler

Sharf

Bombaci³

et al. 2017

J Cancer Res Clin Oncol

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CML Advocates Network and were filled in by patients online and offline. Patient characteristics, treatment and motivations were collected. Adherence was assessed by the 8-item Morisky Medication Adherence scale. Logistic regression models were fitted to investigate the influence of different factors on adherence. Overall, 2 546 questionnaires from 63 countries and 79 CML patient organisations were evaluable. 32.7% of participants were highly adherent, 46.5% were in the medium and 20.7% in the low adherence group. Factors increasing the probability of being in the high adherence group are older age, male sex, management of side effects, only one tablet per day and feeling well informed about CML by the doctor. More than 2 years since diagnosis were significantly lowering the chance as was the use of reminding tools. Living arrangements, multiple medication and personal payment obligations increased the probability to be at least in the medium adherent group. This is the most comprehensive study conducted to date to gain knowledge about factors causing non-adherence in CML. Better information on the disease, medication and management of side effects, supported by haematologists, is key to improve adherence.

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Section: Discussionsupporting

confidence: 79%

Factors influencing adherence in CML and ways to improvement: Results of a patient-driven survey of 2546 patients in 63 countries

Geißler

Sharf

Bombaci³

et al. 2017

J Cancer Res Clin Oncol

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“…Financial stress or distress conveys the extent of worry, anxiety, or anguish about financial decline, either anticipated or actually experienced. Such distress is correlated with poor patient satisfaction [3], higher rates of depression [5], and noncompliance [6,7]. Financial toxicity is a newer term [8] analogous to the physical harm of treatment-related organ toxicity.…”

Section: Introductionmentioning

confidence: 99%

Patient Attitudes Regarding the Cost of Illness in Cancer Care

et al. 2015

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Background and Purpose. The cost of illness in cancer care and the subsequent distress has attracted scrutiny. Guidelines recommend enhanced discussion of costs, assuming this will reduce both stress and costs. Little is known about patient attitudes about cost considerations influencing treatment decisions. Methods. A convenience-sample survey of patients currently receiving radiation and/or intravenous chemotherapy at an outpatient cancer center was performed. Assessments included prevalence and extent of financial burden, level of financial distress, attitudes about using costs to influence treatment decisions, and frequency or desirability of cost discussions with oncologists. Results. A total of 132 participants (94%) responded. Overall, 47% reported high financial stress, 30.8% felt well informed about costs prior to treatment, and 71% rarely spoke to their

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“…19,20) Dusetzina et al reported that 17% of CML patients with higher co-payments discontinued Glivec therapy within the first 180 d, and that 30% of patients with higher co-payments were non-adherent. 8) Kodama et al conducted a retrospective survey of the household incomes of Japanese CML patients, taking into account out-of-pocket medical expenses, final co-payment after refunds, and the perceived financial burden of medical expenses. They found that age, household income, and final co-payments for medical expenses were predictors of Glivec discontinuation.…”

Section: Discussionmentioning

confidence: 99%

“…5) Poor adherence to TKIs results in treatment failure due to the emergence of drug-resistant CML clones; indeed, at least 30% of patients are non-adherent to TKIs, 6,7) a finding that has been linked to the high cost of TKIs. 8) Therefore, the use of generic drugs is encouraged due to the potential cost savings. If a generic formulation is equivalent to the original drug in terms of qualitative and quantitative composition, it can be marketed in Japan as a "generic" without the need to conduct expensive clinical trials (the drug only need undergo pharmacokinetic (PK) testing).…”

mentioning

confidence: 99%

Comparative Study of the Anti-leukemic Effects of Imatinib Mesylate, Glivec™ Tablet and Its Generic Formulation, OHK9511

Yokoo

Kubota

Tabe

et al. 2015

Biological & Pharmaceutical Bulletin

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Long-term treatment with imatinib mesylate (IM) allows patients with chronic myeloid leukemia (CML) to live a near-normal lifespan. However, the fact that tyrosine kinase inhibitors, including IM, are extremely expensive is a major cause of poor adherence, resulting in disease relapse or drug resistance. Therefore, physicians are encouraged to prescribe generic drugs to reduce the financial burden of medical expenses. In Japan, only generic drugs that have a basic chemical structure and pharmacokinetic data that are the same as those of the original drug are approved. However, it is not mandatory to demonstrate that generic drugs have adequate biological effects. This is one of the reasons why Japanese hematologists do not often use generic IM. The aim of the present study was to compare the anti-leukemic effects of Glivec (a commercial IM) and its generic formulation, OHK9511. The IC 50 values of OHK9511 and Glivec were comparable, and both induced similar levels of apoptosis in several CML cell lines. Furthermore, the overall survival of OHK9511-treated mice transplanted with BCR-ABL-positive cells was similar to that of mice treated with Glivec . Although the experiments performed herein were basic, the results suggest that physicians should consider using generic IM.

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Cost Sharing and Adherence to Tyrosine Kinase Inhibitors for Patients With Chronic Myeloid Leukemia

Abstract: Patients with higher copayments are more likely to discontinue or be nonadherent to TKIs. Given the importance of these therapies for patients with CML, our data suggest a critical need to reduce patient costs for these therapies.

Cited by 446 publications

References 28 publications

Factors influencing adherence in CML and ways to improvement: Results of a patient-driven survey of 2546 patients in 63 countries

Factors influencing adherence in CML and ways to improvement: Results of a patient-driven survey of 2546 patients in 63 countries

Patient Attitudes Regarding the Cost of Illness in Cancer Care

Comparative Study of the Anti-leukemic Effects of Imatinib Mesylate, Glivec™ Tablet and Its Generic Formulation, OHK9511

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