Chronic myeloid leukemia treatment intolerance imposes additional resource and economic burden on oncology practices in the United States

Abstract

Objective: Tyrosine kinase inhibitors (TKIs) have transformed the prognosis of chronic myeloid leukemia (CML) into a manageable chronic condition, but TKI intolerance remains a significant issue. This study aimed to quantify the economic burden incurred by oncology practices to manage a CML treatment intolerance episode. Methods: This mixed-methods study leveraged interviews with US oncology practice managers (e.g. physicians, nurse leaders, advanced practice providers) and cost estimation analysis to estimate average time and cost per CML patient treatment intolerance episode, defined as an occurrence of any adverse effect associated with CML treatment from the perspective of an oncology practice. Cost analysis primarily focused on labor costs based on available data from interview responses. Participants were recruited via convenience sampling. Results: N = 10 academic oncology practice managers were interviewed. From the perspective of an oncology practice, average practice time and cost per treatment intolerance episode requiring hospitalization were 34 h and $3,380, driven by payer prior authorization interactions (10 h, $838), additional patient visits (8 h, $858) and inpatient care coordination (9 h, $782). Reimbursable activities represented 31.2% of incurred costs. Conclusion: These findings highlight the significant uncompensated burden placed on oncology practices, raising concerns about how non-reimbursed tasks may affect patient care, staff retention, and the financial sustainability of these practices.