OBJECTIVES: Chronic myeloid leukemia (CML) is a rare cancer that is particularly prevalent among the elderly population. The disease has three phases (chronic, accelerated and blastic) with most patients being diagnosed in the chronic phase (CML-CP). The objective of this study is to estimate the cost of treating CML-CP from the perspective of the Turkish payer organization (SSI).

METHODS: A Modified Delphi Panel approach was used to estimate the costs. A Healthcare Resource Use Questionnaire was designed to cover the type, patient percentage and frequency of resources used for outpatient, inpatient and emergency care of CML. The questionnaire was sent to a panel of experts consisting of six hematologists with clear instructions to be filled out independently. Mean values of the answers were calculated and a single form for discussion in the face-to-face meeting was prepared. During the face-to-face meeting, a consensus document was reached for all answers and resources used at all stages of the disease were determined. SSI reimbursement rules for payment and prices were used to estimate the costs.

RESULTS: The incidence and prevalence of CML are thought to be 1/100,000 and 8/100,000 respectively. CML-CP patients accounted for 93% of all patients. The annual costs of first, second-, and third- or more line treatment per patient were 100,142TRY, 320,490TRY and 357,870TRY respectively. The annual cost of treatment per patient with the T315I mutation was 1,475,182TRY. Based on the epidemiological data from the panel, the annual total cost of CML-CP to the SSI was estimated to be 1,283,203,114TRY. The cost of oncologic drugs was the main cost item.

CONCLUSIONS: In 2023 the total health care expenditures of the SSI were 553,000,000 TRY. Treatment of CML-CP accounted for 0.2% of total expenditures and drug expenditures for CML accounted for 0.7% of the SSI’s drug expenditures.