Treatment patterns, overall survival, healthcare resource use and costs in elderly Medicare beneficiaries with chronic myeloid leukemia using second-generation tyrosine kinase inhibitors as second-line therapy

B Douglas Smith; Jun Liu; Dominick Latremouille-Viau; Annie Guerin; Daniel Fernandez; Lei Chen

doi:10.1185/03007995.2016.1140030

Treatment patterns, overall survival, healthcare resource use and costs in elderly Medicare beneficiaries with chronic myeloid leukemia using second-generation tyrosine kinase inhibitors as second-line therapy

B Douglas Smith, Jun Liu, Dominick Latremouille-Viau, Annie Guerin, Daniel Fernandez, Lei Chen

School of Medicine

Research output: Contribution to journal › Article

Abstract

Objective Though the median age at diagnosis is 64 years, few studies focus on elderly (≥65 years) patients with chronic myeloid leukemia (CML). This study examines healthcare outcomes among elderly Medicare beneficiaries with CML who started nilotinib or dasatinib after imatinib. Research design and methods Patients were identified in the Medicare Research Identifiable Files (2006–2012) and had continuous Medicare Parts A, B, and D coverage. Main outcome measures Treatment patterns, overall survival (OS), monthly healthcare resource utilization and medical costs were measured from the second-line tyrosine kinase inhibitor (TKI) initiation (index date) to end of Medicare coverage. Results Despite similar adherence, dasatinib patients (N = 379) were more likely to start on the recommended dose (74% vs. 53%; p 4.9 years vs. 4.0 years; p = 0.032) and 37% lower mortality risk than dasatinib patients (adjusted HR = 0.63; p = 0.008). Nilotinib patients had 23% fewer inpatient admissions, 30% fewer emergency room visits, 13% fewer outpatient visits (all p

Original language	English (US)
Pages (from-to)	1-11
Number of pages	11
Journal	Current Medical Research and Opinion
DOIs	https://doi.org/10.1185/03007995.2016.1140030
State	Accepted/In press - Feb 9 2016

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Leukemia, Myelogenous, Chronic, BCR-ABL Positive

Medicare

Protein-Tyrosine Kinases

Delivery of Health Care

Costs and Cost Analysis

Survival

Medicare Part A

Medicare Part B

Medicare Part D

Therapeutics

Patient Compliance

Hospital Emergency Service

Inpatients

Research Design

Outpatients

Outcome Assessment (Health Care)

Mortality

Research

Dasatinib

4-methyl-N-(3-(4-methylimidazol-1-yl)-5-(trifluoromethyl)phenyl)-3-((4-pyridin-3-ylpyrimidin-2-yl)amino)benzamide

Keywords

Chronic myeloid leukemia
Healthcare resource use
Medical costs
Medicare
Overall survival
Treatment patterns
Tyrosine kinase inhibitors

ASJC Scopus subject areas

Medicine(all)

Cite this

Smith, B. D., Liu, J., Latremouille-Viau, D., Guerin, A., Fernandez, D., & Chen, L. (Accepted/In press). Treatment patterns, overall survival, healthcare resource use and costs in elderly Medicare beneficiaries with chronic myeloid leukemia using second-generation tyrosine kinase inhibitors as second-line therapy. Current Medical Research and Opinion, 1-11. https://doi.org/10.1185/03007995.2016.1140030

Treatment patterns, overall survival, healthcare resource use and costs in elderly Medicare beneficiaries with chronic myeloid leukemia using second-generation tyrosine kinase inhibitors as second-line therapy. / Smith, B Douglas; Liu, Jun; Latremouille-Viau, Dominick; Guerin, Annie; Fernandez, Daniel; Chen, Lei.

In: Current Medical Research and Opinion, 09.02.2016, p. 1-11.

Research output: Contribution to journal › Article

Smith, BD, Liu, J, Latremouille-Viau, D, Guerin, A, Fernandez, D & Chen, L 2016, 'Treatment patterns, overall survival, healthcare resource use and costs in elderly Medicare beneficiaries with chronic myeloid leukemia using second-generation tyrosine kinase inhibitors as second-line therapy', Current Medical Research and Opinion, pp. 1-11. https://doi.org/10.1185/03007995.2016.1140030

Smith BD, Liu J, Latremouille-Viau D, Guerin A, Fernandez D, Chen L. Treatment patterns, overall survival, healthcare resource use and costs in elderly Medicare beneficiaries with chronic myeloid leukemia using second-generation tyrosine kinase inhibitors as second-line therapy. Current Medical Research and Opinion. 2016 Feb 9;1-11. https://doi.org/10.1185/03007995.2016.1140030

Smith, B Douglas ; Liu, Jun ; Latremouille-Viau, Dominick ; Guerin, Annie ; Fernandez, Daniel ; Chen, Lei. / Treatment patterns, overall survival, healthcare resource use and costs in elderly Medicare beneficiaries with chronic myeloid leukemia using second-generation tyrosine kinase inhibitors as second-line therapy. In: Current Medical Research and Opinion. 2016 ; pp. 1-11.

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10.1185/03007995.2016.1140030