Pharmacoeconomic benefits of dasatinib in the treatment of imatinib-resistant patients with chronic myelogenous leukemia.
Treatment with imatinib has demonstrated high response rates and improved prognosis in chronic myelogenous leukemia. However, while the short-term response to imatinib is high, there are some concerns that the long-term response is substantially lower. Durable response with imatinib is difficult to achieve in patients with resistant disease. The use of higher doses has also been associated with increased toxicity and intolerance. Dasatinib is a new SRC-ABL-kinase inhibitor that has been developed for treating chronic myelogenous leukemia patients, across all phases of disease, who are resistant or intolerant to imatinib. This article details the existing evidence on the clinical efficacy, safety and value for money of dasatinib in the treatment of imatinib-resistant and -intolerant patients with chronic myelogenous leukemia. Dasatinib is associated with higher levels of response compared with high-dose imatinib. In addition, higher levels of response are associated with improved health outcomes in terms of both quality- and quantity-of-life years.
Taylor
Matthew J
MJ
York Health Economics Consortium Ltd, Market Square, University of York, York, YO10 5NH, UK. mt25@york.ac.uk
Scuffham
Paul A
PA
D000818:Animals; D000970:Antineoplastic Agents / Q000191:economics* / Q000627:therapeutic use*; D001549:Benzamides; D003365:Costs and Cost Analysis; D000069439:Dasatinib; D019008:Drug Resistance, Neoplasm; D006801:Humans; D000068877:Imatinib Mesylate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000191:economics*; D010879:Piperazines / Q000191:economics* / Q000627:therapeutic use*; D047428:Protein Kinase Inhibitors / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use*; D011743:Pyrimidines / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use*; D011788:Quality of Life; D013844:Thiazoles / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use*; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D047428:Protein Kinase Inhibitors; D011743:Pyrimidines; D013844:Thiazoles; D000068877:Imatinib Mesylate; D000069439:Dasatinib