title: Cost-effectiveness of Tyrosine Kinase Inhibitor Treatment Strategies for Chronic Myeloid Leukemia in Chronic Phase After Generic Entry of Imatinib in the United States.
abstract: BACKGROUND
  We analyzed the cost-effectiveness of treating incident chronic myeloid leukemia in chronic phase (CML-CP) with generic imatinib when it becomes available in United States in 2016. In the year following generic entry, imatinib's price is expected to drop 70% to 90%. We hypothesized that initiating treatment with generic imatinib in these patients and then switching to the other tyrosine-kinase inhibitors (TKIs), dasatinib or nilotinib, because of intolerance or lack of effectiveness ("imatinib-first") would be cost-effective compared with the current standard of care: "physicians' choice" of initiating treatment with any one of the three TKIs.
  
  
  METHODS
  We constructed Markov models to compare the five-year cost-effectiveness of imatinib-first vs physician's choice from a US commercial payer perspective, assuming 3% annual discounting ($US 2013). The models' clinical endpoint was five-year overall survival taken from a systematic review of clinical trial results. Per-person spending on incident CML-CP treatment overall care components was estimated using Truven's MarketScan claims data. The main outcome of the models was cost per quality-adjusted life-year (QALY). We interpreted outcomes based on a willingness-to-pay threshold of $100 000/QALY. A panel of European LeukemiaNet experts oversaw the study's conduct.
  
  
  RESULTS
  Both strategies met the threshold. Imatinib-first ($277 401, 3.87 QALYs) offered patients a 0.10 decrement in QALYs at a savings of $88 343 over five years to payers compared with physician's choice ($365 744, 3.97 QALYs). The imatinib-first incremental cost-effectiveness ratio was approximately $883 730/QALY. The results were robust to multiple sensitivity analyses.
  
  
  CONCLUSIONS
  When imatinib loses patent protection and its price declines, its use will be the cost-effective initial treatment strategy for CML-CP.
authors.affiliation: Affiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
authors.forename: William V
authors.initials: WV
authors.lastname: Padula
authors.affiliation: Affiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
authors.forename: Richard A
authors.initials: RA
authors.lastname: Larson
authors.affiliation: Affiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
authors.forename: Stacie B
authors.initials: SB
authors.lastname: Dusetzina
authors.affiliation: Affiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
authors.forename: Jane F
authors.initials: JF
authors.lastname: Apperley
authors.affiliation: Affiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
authors.forename: Rudiger
authors.initials: R
authors.lastname: Hehlmann
authors.affiliation: Affiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
authors.forename: Michele
authors.initials: M
authors.lastname: Baccarani
authors.affiliation: Affiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
authors.forename: Ekkehard
authors.initials: E
authors.lastname: Eigendorff
authors.affiliation: Affiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
authors.forename: Joelle
authors.initials: J
authors.lastname: Guilhot
authors.affiliation: Affiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
authors.forename: Francois
authors.initials: F
authors.lastname: Guilhot
authors.affiliation: Affiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
authors.forename: Rudiger
authors.initials: R
authors.lastname: Hehlmann
authors.affiliation: Affiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
authors.forename: Francois-Xavier
authors.initials: FX
authors.lastname: Mahon
authors.affiliation: Affiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
authors.forename: Giovanni
authors.initials: G
authors.lastname: Martinelli
authors.affiliation: Affiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
authors.forename: Jiri
authors.initials: J
authors.lastname: Mayer
authors.affiliation: Affiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
authors.forename: Martin C
authors.initials: MC
authors.lastname: Müller
authors.affiliation: Affiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
authors.forename: Dietger
authors.initials: D
authors.lastname: Niederwieser
authors.affiliation: Affiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
authors.forename: Susanne
authors.initials: S
authors.lastname: Saussele
authors.affiliation: Affiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
authors.forename: Charles A
authors.initials: CA
authors.lastname: Schiffer
authors.affiliation: Affiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
authors.forename: Richard T
authors.initials: RT
authors.lastname: Silver
authors.affiliation: Affiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
authors.forename: Bengt
authors.initials: B
authors.lastname: Simonsson
authors.affiliation: Affiliations of authors:Department of Health Policy and Management, Johns Hopkins University , Baltimore, MD (WVP); Department of Medicine (RAL) and Departments of Pediatrics and of Public Health Sciences (RMC), University of Chicago, Chicago, IL; Eshelman School of Pharmacy and Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center , and Cecil G. Sheps Center for Health Services Research, University of North Carolina , Chapel Hill, NC (SBD); Department of Haematology, Hammersmith Hospital, Imperial College , London , UK (JFA); Department of Medicine (RH, SS) and Department of Hematology and Oncology (MCM), University of Heidelberg, Mannheim, Germany; Department of Haematology and Oncology, S. Orsola-Malpighi University Hospital (MB), and Department of Hematology, "L. e A. Seragnoli" (GM), University of Bologna , Bologna , Italy ; Department of Haematology and Oncology, University Hospital , Jena , Germany (EE); INSERM Centre d'Investigation Clinique (CIC) 1402, CHU de Poitiers, Poitiers, France (JG, FG); Laboratoire d'Hematologie, Universite Victor Segalen, Bordeaux, Pessac, France (FXM); Department of Internal Medicine, Hematology and Oncology, University Hospital Brno , Brno , Czech Republic (JM); Department of Hematology and Oncology, University Hospital Leipzig , Leipzig , Germany (DN); Barbara Ann Karmanos Cancer Institute, Wayne State University , Detroit, MI (CAS); Department of Medicine, Weill Cornell Medical Center , New York, NY (RTS); Uppsala University , Uppsala , Sweden (BS).
authors.forename: Rena M
authors.initials: RM
authors.lastname: Conti
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000191:economics* / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D016568:Drugs, Generic / Q000191:economics / Q000627:therapeutic use; D005260:Female; D006801:Humans; D000068877:Imatinib Mesylate / Q000191:economics* / Q000627:therapeutic use*; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000191:economics* / Q000401:mortality; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D017059:Models, Econometric; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000639:trends; D047428:Protein Kinase Inhibitors / Q000191:economics* / Q000627:therapeutic use*; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors*; D019057:Quality-Adjusted Life Years; D016019:Survival Analysis; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
chemical_list: D000970:Antineoplastic Agents; D016568:Drugs, Generic; D047428:Protein Kinase Inhibitors; D000068877:Imatinib Mesylate; D011505:Protein-Tyrosine Kinases