OBJECTIVES: To evaluate the social and economic burden of chronic myeloid leukemia (CML) in Bulgaria presented as disability adjusted life years (DALYs).

METHODS: A retrospective analysis was performed on the basis of officially published information in the national cancer registry and local representative studies. Data for the relevant survival and the average year of diagnosis of patients with CML in the country were gathered and analyzed. DALYs were calculated as the sum of the Years of Life Lost (YLL) and the Years Lost due to Disability (YLD). Disability weight, the average life expectancy and the median survival were assumed to be 0.049 (0,031-0,072) as it is in case of controlled phase of CML, 88 years of age as per WHO methodology and 25 years according to expert opinions, respectively. The average age of CML diagnosis for Bulgarian population is 53±16 years according to nationally representative study conducted between 2012 and 2014. DALYs were multiplied by the GDP/capita so as to find the economic burden of the disease.

RESULTS: On average a patient with CML in controlled phase spends 10.89 years of his remaining life in disability due to the disease. Taking into account annual working income we found that the costs of lost productivity per patient are supposed to be around 66 398.5 (63 623 – 69 906) €.

CONCLUSIONS: The current study is the first Bulgarian one which evaluates the social burden of CML after placing innovative tyrosine kinase inhibitors on the Bulgarian market. The disease appears to have high social and economic burden which is comparable with the burden of other non-communicable chronic diseases in Bulgaria.