AIM: A cost-effectiveness analysis was performed for sequential treatments of @entity1860 ( @entity1860 ) with @entity4149 kinase inhibitors (TKIs) after failure of 1st line @entity2213 , from a commercial payer perspective in the US. METHODS: A Markov model was developed to simulate lifetime treatment costs and health outcomes for TKI sequences for treatment of @entity1 resistant or intolerant to 1st-line @entity2213 . Five health states were included, chronic phase 2nd-line TKI, chronic phase 3rd-line TKI, chronic phase post-TKI, advanced phases, and @entity204 . Efficacy (response achievement, loss of response, transformation, @entity204 ) and safety (adverse events incidence, discontinuation) data are based on clinical trials. Resource utilization, costs, and utilities were based on product labels and publically available data. Uncertainty analyses were conducted for key inputs. RESULTS: In @entity1 failing @entity2213 , @entity8947 -initiating treatment sequences provide the most survival (  LYs   =   0.2-2.0), QALYs (  QALYs   =   0.2-1.9), and accrue highest @entity1860 -related costs (  Costs   =    64,000- 222,000). The average @entity10679 per QALY for @entity8947 - vs @entity2213 -initiating sequences is  100,000 for an @entity2213 -resistant population. The average @entity10679 per QALY for @entity8947 - vs @entity10542 -initiating sequences is  170,000 for an @entity2213 -resistant population, and  160,000 for an @entity2213 -intolerant population. CONCLUSIONS: This analysis suggests that @entity8947 is associated with increased survival and quality of life compared to high dose @entity2213 and to a smaller extent with @entity10542 , among @entity1 resistant or intolerant to 1st-line @entity2213 , primarily based on higher cytogenetic response rates observed in clinical studies of @entity8947 . Head-to-head studies of sequential use of @entity8947 and @entity10542 are needed to validate the model findings of improved survival (LYs) with better quality-of-life (QALYs) for @entity1 initiating @entity8947 in 2nd-line. However, the model findings (in light of higher cytogenetic response rates with @entity8947 ) are supported by other studies showing improved quality-of-life for responders, and improved survival for @entity1 achieving cytogenetic response.

Cost-effectiveness analysis of second-line @entity4149 kinase inhibitor treatment for XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity8947 :: ('MESH:C488369', 'Chemical') :: ['dasatinib'] @entity10679 :: ('1390', 'Gene') :: ['ICER'] @entity4149 :: ('D014443', 'Chemical') :: ['tyrosine'] @entity1860 :: ('MESH:D015464', 'Disease') :: ['CML', 'chronic myelogenous leukemia'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death'] @entity10542 :: ('MESH:C498826', 'Chemical') :: ['nilotinib'] @entity2213 :: ('MESH:C097613', 'Chemical') :: ['imatinib']
@entity1860 :: (MESH:D015464,Disease) :: ['chronic myelogenous leukemia']
