Societal implications of medical insurance coverage for imatinib as first-line treatment of chronic myeloid leukemia in China: a cost-effectiveness analysis

Abstract

The insurance coverage of imatinib is very cost-effective in China, according to the local cost and clinical data in Jiangsu province. More importantly, the insurance coverage of imatinib and nilotinib have changed the treatment patterns of CML patients, thus dramatically increasing life expectancy and quality-of-life (QoL) saving on productivity losses for both CML patients and their caregivers.

<p>Retroperitoneal Extragastrointestinal Stromal Tumors Have a Poor Survival Outcome: A Multicenter Observational Study</p>

“… 27 – 31 However, no valid conclusion can be drawn on the efficacy of imatinib in the treatment of eGISTs due to a limited number of reported cases, low compliance to long-term treatment, and absence of comparative arm analyses. The lack of compliance to TKI prescription may be summarized to the expensive cost of imatinib (during the study period), 32 , 33 low awareness on the treatment of GISTs, 34 and poor adherence to long-term treatment which is often associated with increased risk of side-effects of the drugs. 35 Further, due to the rarity of this disease, we believe a wide interinstitutional and multi-country collaboration would be needed to first, demystify the localization of eGISTs and second, to properly assess the actual efficacy of imatinib in eGISTs.…”

Can the Consideration of Societal Costs Change the Recommendation of Economic Evaluations in the Field of Rare Diseases? An Empirical Analysis

“…Intervention type outcome in the assessment, and 11 did not provide separate results according to both perspectives so it was not possible to extract the data from the results. Hence, 14 articles satisfied all the inclusion criteria [27][28][29][30][31][32][33][34][35][36][37][38][39][40][32][33][34][35][36][37][38][39][40][41][42][43][44][45] and were finally included. With respect to the perspective used in the studies included in the review, half of the studies used both that of the healthcare payer and the wider perspective (the societal approach) in the analyses.…”

“…With respect to the perspective used in the studies included in the review, half of the studies used both that of the healthcare payer and the wider perspective (the societal approach) in the analyses. 32,33,[35][36][37][38][39] However, 5 studies used the societal perspective as the main perspective, but the healthcare payer's perspective could be extracted from the tables. 40,[42][43][44][45] On the other hand, 2 studies used the healthcare provider's perspective as the main perspective but included the societal perspective in the sensitivity analysis.…”

“…Informal care costs were included in only 5 studies, 32,33,37,40,43 and the opportunity cost method was used in 4 of them 32,33,40,43 ; however, Wilson et al did not state clearly the valuation method used. 37 Landfelt et al 33 used a Markov model to carry out the economic evaluation, and they estimated the burden of informal care by avoiding the double accounting of the cost of care provided via nurses' visits and by allowing an unadjusted estimate of indirect costs due to the loss of productivity of the main informal caregiver.…”

“…Productivity losses were considered in 12 articles, [32][33][34][35][36][37][38][39]41,42,44,45 and the human capital approach was used in most of them, [32][33][34][35][36][37][38]41,42,44,45 although the authors from one study did not provide the method used in the assessment of productivity losses. 39 Regarding the inclusion of production lost in the productivity losses, in 3 studies the caregivers' absences WE, work-paid time loss due to an early retirement; WM, work-paid loss time due to premature mortality; WP, work-paid loss time due to presenteeism.…”