Presentation (CTI)

OBJECTIVES: Tyrosine kinase inhibitors (TKIs) in the first-line treatment of chronic myeloid leukaemia (CML) have increased their efficacy from the 1st generation (imatinib), through the 2nd (bosutinib, dasatinib and nilotinib), to the 3rd (asciminib). However, these have different safety profiles, both in the type of adverse events and in the frequency with which they occur. Adverse events compromise the efficacy of TKIs by requiring dose reductions, temporary interruptions, or treatment substitutions and they have an economic impact The objetive os this research is to determine the mean cost of treatment per patient of adverse events of the different TKI generations in the first-line treatment of CML for the Spanish National Health System.
METHODS: The adverse events of each TKI, their frequency and their treatment were obtained from data from the literature, consultation with three experts and a consensus in a panel of these experts. From these, beta distributions of probability of the occurrence of the event were obtained. The gamma distributions of the costs of each event and resources were obtained from the official tariff of the Spanish Autonomous Communities (all cost in €2026). 10,000 simulations were carried out using the Monte Carlo method to obtain an average cost per adverse events for each treatment.
RESULTS: The mean cost of adverse events per patient was €1,195.50 (SD 905.98) for first generation TKI (imatinb) versus €553.48 (SD 512,48), second generation TKIs (bosutinib, dasatinib and nilotinib) and €467.33 (SD 436,07) for third generation TKI (asciminib).
CONCLUSIONS: The increase in efficacy represented by the new generations of TKI is accompanied by a better safety profile that means a reduction in the costs of treating adverse events. Knowing it can contribute to select the most appropriate therapeutic alternative