OBJECTIVES : To analyze the costs of tyrosine kinase inhibitor (TKI) therapy on the treatment of chronic myeloid leukemia (CML) from the patients perspective within one year and identified influenced factors.

METHODS : A multicenter observational study was conducted including 440 CML patients who were aged 18 or above, used TKI at least 1 year and visited Hematology Outpatient Units from October 2018 to December 2019. The medical direct costs and disease information were collected from medical records. Socio-demographic information, nonmedical and indirect costs were collected via face-to-face interviews. The influence of socio-demographic and disease characteristics on the costs was identified by Bayesian Model Averaging (BMA) method.

RESULTS : Patients had the average age of 46.8 (SD=14.4) years, the male: female rate of 1.47:1 and the proportion of imatinib frontline treatment of 76.4%. Most patients had education of under high school, were married, earned low monthly incomes and lived far from hospitals. Average monthly costs of TKI therapy were $US567.6 thus reaching $US7,451 per year per patient. TKI drug costs accounted for the highest percentage (87.1%) while nonmedical costs and indirect costs got only 5% in the total treatment cost. Patients using nilotinib as second-choice had the total cost of $US6,395 and total outpatient follow-up visits of 14 times per year which were higher than imatinib 1,69 and 1,06 times, respectively. Based on post probability and Bayesian Information Criterion from BMA analysis, model with 4 factors including marital status, occupation, duration of diagnosis and duration of TKI use affected the total cost. This model explained 10.7% variance of costs.

CONCLUSIONS : Direct medical costs were the main cost burden of CML patients where the TKI drug was the main cost driver. The total cost was mainly influenced by marital status, occupation, time from diagnosis and TKI use.