Budget impact analysis of treatment-free remission in chronic myeloid leukemia patients treated with nilotinib in Tunisia

Abstract

Background

The emergence of treatment-free remission marks a significant shift in clinical management for chronic myeloid leukemia patients. It involves the discontinuation of tyrosine kinase inhibitors therapy while maintaining a sustained molecular response. In light of this, the study aims to evaluate the budget impact associated with this healthcare strategy among tunisian patients treated with nilotinib. This economic evaluation seeks to provide insights into the affordability of implementing treatment-free remission from the perspective of the Tunisian National Health Insurance Fund.

Methods

Over a three-year time horizon, a Markov model assessed the introduction of treatment-free remission in an eligible population. The input data used for transition probabilities and identification of the target population were obtained from a systematic literature review. The economic evaluation considered only the drug acquisition cost as the direct cost covered by the public payer. To account for the variability of results, a one-way deterministic sensitivity analysis was conducted by varying key model parameters.

Results

From an initial cohort of 32 eligible patients within the health insurance database, the model estimated the evolution of the target population to 230 patients after three years. The introduction of treatment-free remission as a new strategy in the management of chronic myeloid leukemia would result in a cost-saving estimated at 23.4 million Tunisian Dinars. The uncertainty analysis revealed the significant impact of drug prices on the overall outcomes.

Conclusion

This study provides transparent and interpretable results for decision-makers. The economic evaluation reveals a financial gain that can be allocated to address other health priorities within the Tunisian National Health Insurance Fund’s budget.

Policy summary

The budget impact analysis advocates for implementing treatment-free remission as a cost-saving intervention for the Tunisian National Health Insurance Fund’s budget.