Author’s Reply
Jul 1, 2021, 00:00 AM
10.1016/j.jval.2020.12.025
https://www.valueinhealthjournal.com/article/S1098-3015(21)00161-3/fulltext
Section Title :
LETTERS TO THE EDITOR
Section Order :
1086
First Page :
1086
We thank Dr. Cho for the critical review of our study on the cost effectiveness of tyrosine kinase inhibitors (TKIs) in newly treated patients with chronic myeloid leukemia (CML). Ultimately, as with many decision models, we did not have perfect information for some key elements, and, thus, weighed the added benefit of including additional assumptions in the model where there was a lack of clear data (eg, associated disutilities or probability of treatment-free survival). We also recognize that disease progression is an important feature to consider in oncology. This can and previously has been studied in the same clinical context using transition state models, including those by Padula et al using a Markov model and 5-year time horizon that was recently updated by Yamamoto et al to incorporate treatment discontinuation. However, disease progression while on a TKI is rare. Treatment switching is also uncommon beyond the first year, and we expect that the vast majority of patients will remain on their initiated or second-line TKI in the first year. Our study’s primary aim was to address an area that was missing from prior studies, which is the inclusion of differential adverse event (AE) profiles across the available TKIs in newly treated patients with CML. We know that the majority of AEs associated with TKIs occur within the first year after treatment initiation and new AEs after the first year have been rare. Our goal was to complement previous findings by incorporating an important decision point related to initial treatment selection for newly-diagnosed CML.
https://www.valueinhealthjournal.com/action/showCitFormats?pii=S1098-3015(21)00161-3&doi=10.1016/j.jval.2020.12.025
HEOR Topics :
- Clinical Outcomes
- Clinician Reported Outcomes
- Patient-Centered Research
- Specialized Treatment Areas