1 Department of Pharmacy, Faculty of Medicine, Oran/ Algeria.
2 Department of Pharmacovigilance, University Hospital of Oran.
3 Department of Hematology, University Hospital of Oran.
4 Department of Pharmacy, Faculty of Medicine, Tlemcen.
Research Article
GSC Biological and Pharmaceutical Sciences, 2025, 33(02), 082-092.
Article DOI: 10.30574/gscbps.2025.33.2.0430
Received on 26 September 2025; revised on 01 November 2025; accepted on 04 November 2025
Introduction: Chronic myeloid leukemia (CML) prognosis has been dramatically improved by tyrosine kinase inhibitors (TKIs). Imatinib remains the standard first-line therapy, while Dasatinib and Nilotinib are used in cases of resistance or intolerance. Their high cost raises concerns of sustainability in resource-limited settings, justifying local pharmacoeconomic evaluations.
Patients and Methods: An observational study was conducted on 63 patients with chronic-phase CML. Quality of life was assessed using the EQ-5D, converted into QALYs. Direct medical costs (treatments, monitoring, adverse events) were collected over 12 months from two perspectives: hospital and societal. QALYs and costs were adjusted using regression analysis, and efficiency was measured through cost/QALY and ICUR.
Results/discussion: Imatinib showed the best cost-utility ratio in first-line therapy, with a cost/QALY well below the Algerian willingness-to-pay threshold (≈ 4,747 USD). Drug acquisition represented the main cost driver. In second-line therapy, Nilotinib provided only a limited benefit (+0.047 QALY) but with a substantial additional cost (~30,000 USD), resulting in an ICUR > 630,000 USD/QALY, far exceeding the threshold. Dasatinib thus appeared more cost-effective. Transition to second-line treatment and severe adverse events significantly impaired quality of life.
Conclusion: Imatinib remains the most cost-effective strategy in first-line therapy, while Dasatinib is economically more rational than Nilotinib in second-line therapy. The use of TKIs should balance clinical efficacy, quality of life, and economic sustainability.
Pharmacoeconomic evaluations; Cost Effectiveness; Chronic myeloid leukemia; Tyrosine kinase inhibitors; QALYs; Quality of life
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Hamza BENBACHIR, Wiam HABERROU, Manel OUSSAR, Kawther SAIAH, Badra ENTASULTAN and Mustapha BERRICHI. Cost Effectiveness Analysis of Tyrosine Kinase Inhibitors in the Management of Chronic Myeloid Leukemia. GSC Biological and Pharmaceutical Sciences, 2025, 33(2), 082-092. Article DOI: https://doi.org/10.30574/gscbps.2025.33.2.0430