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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
Author(s) -
Daroudi Rajabali,
Mirzania Mehrzad,
Nikravanfard Nazila,
Sadighi Sanambar,
Sedighi Zahra,
Zendehdel Kazem
Publication year - 2017
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/ajco.12470
Subject(s) - myeloid leukemia , estimation , tyrosine kinase , medical costs , medicine , cancer research , health care , economics , economic growth , receptor , management
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.