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Research Letter
October 1, 2020

Association of Generic Imatinib Availability and Pricing With Trends in Tyrosine Kinase Inhibitor Use in Patients With Chronic Myelogenous Leukemia

Author Affiliations
  • 1Public Health Sciences and Clinical Research Divisions, Fred Hutchinson Cancer Research Center, Seattle, Washington
  • 2Department of Medicine, University of Washington, Seattle
  • 3OptumLabs, Eden Prairie, Minnesota
JAMA Oncol. 2020;6(12):1969-1971. doi:10.1001/jamaoncol.2020.4660

The increasing price of new cancer therapies over the past 3 decades has contributed considerably to increasing health care expenditures. The life expectancy of patients with chronic myelogenous leukemia (CML) treated with imatinib now approaches that of the general population, increasing the prevalence of survivors with CML receiving treatment.1 Beginning in 2006, a series of second- and third-generation tyrosine kinase inhibitors (TKIs) have been approved and gained widespread use based on early results demonstrating deeper molecular responses.2,3 However, subsequent studies have provided no evidence that later-generation TKIs provide superior progression free or overall survival compared with imatinib.4-6 Although a generic imatinib was approved in 2016, high initial prices of brand name and generic imatinib and next-generation TKIs have continued to increase, averaging 10% to 20% annually, contributing to financial hardship and possibly poor compliance with effective therapy (https://ascopubs.org/doi/10.1200/JOP.2016.019737). In this article, we provide contemporary data to identify trends in TKI use in patients with CML and the association those treatment choices have with health care costs.

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