title: Estimation of the prevalence and direct medical costs of chronic myeloid leukemia in the I.R. of Iran in the era of tyrosine kinase inhibitors.
abstract: BACKGROUND
  After the introduction of tyrosine kinase inhibitors for chronic myeloid leukemia (CML), the survival of these patients has increased significantly. However, these new drugs are expensive and impose considerable expense to patients and governments. Epidemiologic and economic evaluation studies provide good information for resource allocation and decision making. We estimated the incidence, prevalence and direct medical cost of CML in Iran.
  
  
  METHODS
  We used the National Cancer Registry (NCR) data from 2006 to 2009 to estimate the incidence rate of CML (ICD-10 code C92.1). After adjustment for the underestimation of incidence rates, we used survival rates of CML and estimated the 5-year prevalence for these patients. In addition, we used clinical practice guideline, expert opinions and medical tariffs to estimate the direct medical costs through the prevalence approach.
  
  
  RESULTS
  After an adjustment for the underestimation, the incidence rate of CML was 0.5 per 100 000 in the I.R. of Iran. The 5-year prevalence was about 2263 cases (2.98 per 100 000). The total direct medical cost of CML was $23 089 323 and the majority of the cost (97%) was related to drug costs. The total cost will increase considerably to $40 728 869 if all patients use the new drug nilotinib (800 mg/day) as a second-line treatment.
  
  
  CONCLUSIONS
  The increased survival of CML patients and a possible increase in incidence of CML in Iran will most likely lead to a considerable rise in its prevalence and economic burden.
authors.affiliation: Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences (TUMS), Tehran, I.R of Iran.|Department of Health Economics and Management, School of Public Health, TUMS, Tehran, I.R of Iran.
authors.forename: Rajabali
authors.initials: R
authors.lastname: Daroudi
authors.affiliation: Hematology and Medical Oncology Group, Cancer Research Center, Cancer Institute, Imam Khomeini Hospital Complex, TUMS, Tehran, I.R of Iran.
authors.forename: Mehrzad
authors.initials: M
authors.lastname: Mirzania
authors.affiliation: Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences (TUMS), Tehran, I.R of Iran.|National Research Ethics Committee, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, I.R of Iran.
authors.forename: Nazila
authors.initials: N
authors.lastname: Nikravanfard
authors.affiliation: Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences (TUMS), Tehran, I.R of Iran.
authors.forename: Sanambar
authors.initials: S
authors.lastname: Sadighi
authors.affiliation: Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences (TUMS), Tehran, I.R of Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Sedighi
authors.affiliation: Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences (TUMS), Tehran, I.R of Iran.|Cancer Models Research Center, Cancer Institute of Iran, TUMS, Tehran, I.R of Iran.
authors.forename: Kazem
authors.initials: K
authors.lastname: Zendehdel
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D015994:Incidence; D007492:Iran / Q000453:epidemiology; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000191:economics* / Q000453:epidemiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D047428:Protein Kinase Inhibitors / Q000191:economics / Q000627:therapeutic use; D011505:Protein-Tyrosine Kinases / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use*; D015996:Survival Rate
chemical_list: D047428:Protein Kinase Inhibitors; D011505:Protein-Tyrosine Kinases
keywords: Iran; chronic myeloid; cost; leukemia; prevalence