TKI Use in Medicare Beneficiaries With Chronic Myeloid Leukemia

March 22, 2017
Lisa Schulmeister, RN, MN, APRN-BC, FAAN

A recent study found that out-of-pocket costs could be a barrier to timely initiation of TKI therapy among individuals with Medicare coverage.

Researchers from the University of North Carolina at Chapel Hill, Harvard Medical School, and Brigham and Women’s Hospital conducted a study of SEER-Medicare data to examine factors associated with initiation of and adherence to tyrosine kinase inhibitors (TKIs) among Medicare beneficiaries with chronic myeloid leukemia (CML). An objective of the study was to determine whether or not cost sharing or other patient- or provider-level factors are barriers to TKI use.

The researchers identified individuals diagnosed with CML from 2007 to 2011 and assessed time from diagnosis to TKI initiation and adherence, which they defined as taking the TKI for at least 80% of the first 180 days following TKI initiation.

Among the 393 individuals in the study, only 68% initiated TKI treatment within 180 days after diagnosis. About one-third of the patients started TKI treatment at a later point in time, primarily due to insurance coverage issues and out-of-pocket costs. Among TKI initiators, 61% were adherent; however, adherence was lower for individuals aged 80 years or older versus those aged 66 to 69 years.

The researchers concluded that out-of-pocket costs may be a barrier to timely initiation of TKI therapy among individuals with Medicare coverage. The study findings are available here.