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

Research output: Contribution to journalArticle

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 languageEnglish (US)
Pages (from-to)1-11
Number of pages11
JournalCurrent Medical Research and Opinion
DOIs
StateAccepted/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

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title = "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",
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 ",
keywords = "Chronic myeloid leukemia, Healthcare resource use, Medical costs, Medicare, Overall survival, Treatment patterns, Tyrosine kinase inhibitors",
author = "Smith, {B Douglas} and Jun Liu and Dominick Latremouille-Viau and Annie Guerin and Daniel Fernandez and Lei Chen",
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T1 - 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

AU - Smith, B Douglas

AU - Liu, Jun

AU - Latremouille-Viau, Dominick

AU - Guerin, Annie

AU - Fernandez, Daniel

AU - Chen, Lei

PY - 2016/2/9

Y1 - 2016/2/9

N2 - 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 

AB - 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 

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KW - Overall survival

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