{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T16:37:14Z","timestamp":1787503034495,"version":"build-2736575974"},"reference-count":24,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi231401-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Patients with chronic myeloid leukemia (CML) who have a sustained deep molecular response using tyrosine kinase inhibitors (TKIs) can safely attempt to stop their use. As these medications are very costly, this change in treatment protocols may result in large savings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi231401-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To estimate future savings from attempting to stop TKI use among patients with CML who have deep molecular response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi231401-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>A microsimulation model was developed for this decision analytical modeling study to estimate costs for US adults moving from using a TKI, to attempting discontinuation and then reinitiating TKI therapy, if clinically appropriate. Estimates were calculated for US patients who currently have CML and simulated newly diagnosed cohorts of patients over the next 30 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi231401-7\">\n                    <jats:title>Exposure<\/jats:title>\n                    <jats:p>Attempting to stop using a TKI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi231401-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>Estimated savings after attempted discontinuation of TKI use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi231401-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A simulated population of individuals with CML in 2018 and future populations were created using estimates from the SEER*Explorer website. The median age at diagnosis was 66 years for men and 65 years for women. Between 2022 and 2052, the savings associated with eligible patients attempting discontinuation of TKI therapy was estimated at more than $30 billion among those currently diagnosed and over $15 billion among those who will develop CML in the future, for a total savings of over $54 billion by 2052 for drug treatment and polymerase chain reaction testing. The estimate is conservative as it does not account for complications and other health care\u2013associated costs for patients continuing TKI therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi231401-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>The findings of this decision analytical modeling study of patients with CML suggest that attempting discontinuation of TKI therapy could save over $54 billion during the next 30 years. Further education for patients and physicians is needed to safely increase the number of patients who can successfully attain treatment-free remission.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.47950","type":"journal-article","created":{"date-parts":[[2023,12,18]],"date-time":"2023-12-18T11:01:08Z","timestamp":1702897268000},"page":"e2347950","source":"Crossref","is-referenced-by-count":10,"title":["Estimated Savings After Stopping Tyrosine Kinase Inhibitor Treatment Among Patients With Chronic Myeloid Leukemia"],"prefix":"10.1001","volume":"6","author":[{"given":"Aaron N.","family":"Winn","sequence":"first","affiliation":[{"name":"Department of Health Systems, Outcomes and Policy, School of Pharmacy, University of Illinois at Chicago"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ehab","family":"Atallah","sequence":"additional","affiliation":[{"name":"Department of Medicine, Medical College of Wisconsin, Milwaukee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Cortes","sequence":"additional","affiliation":[{"name":"Georgia Cancer Center, Augusta University Medical Center, Augusta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael W. 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Lee Moffitt Cancer Center & Research Institute, Tampa, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerald P.","family":"Radich","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Research Center, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil P.","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of California at San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James E.","family":"Thompson","sequence":"additional","affiliation":[{"name":"Roswell Park Comprehensive Cancer Center, Buffalo, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn E.","family":"Flynn","sequence":"additional","affiliation":[{"name":"Department of Medicine, Medical College of Wisconsin, 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