{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T21:08:14Z","timestamp":1775250494176,"version":"3.50.1"},"reference-count":18,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"4","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Glob Oncol"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>\n                      Tyrosine kinase inhibitors are available in the Brazilian public health care system. However, reimbursement challenges limit access to molecular testing of\n                      <jats:italic toggle=\"yes\">BCR::ABL-1<\/jats:italic>\n                      , which is essential for diagnosing and monitoring measurable residual disease in chronic myeloid leukemia (CML). This study estimated the costs associated with delivering the\n                      <jats:italic toggle=\"yes\">BCR::ABL-1<\/jats:italic>\n                      test in a tertiary academic reference care center in Brazil and simulated alternatives to increase patient access to the test.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This is an economic analysis that estimates the costs based on resource consumption from a hospital to deliver a specific health care service, following the steps of the time-driven activity-based costing method at an academic reference center in Brazil. With the costs per test calculated, a scenario analysis estimated the budget impact resulting from an increase in test volume and a decrease in kit purchase cost, considering the local incidence of the disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>The cost per test was R$717, and if only laboratory reagents and personnel were considered, delivering the test to one patient accounted for R$556, whereas the current reimbursement fee is R$144. The simulated scenarios indicate that by increasing the volume of tests delivered by 60% and renegotiating the acquisition cost with the supplier in the same proportion, it is possible to cover 63% of the regional demand without increasing the budget impact.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>\n                      The financial and access challenges explored in this study underscore the importance of accelerating more effective and sustainable health policies in the CML field, which include access to the\n                      <jats:italic toggle=\"yes\">BCR::ABL-1<\/jats:italic>\n                      test with financial accountability.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/go-25-00724","type":"journal-article","created":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T19:59:14Z","timestamp":1775246354000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Breaking Barriers: Reducing Costs and Overcoming Challenges in\n                    <i>BCR::ABL-1<\/i>\n                    Monitoring for Chronic Myeloid Leukemia in Brazil"],"prefix":"10.1200","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6411-3480","authenticated-orcid":true,"given":"Ana Paula Beck da Silva","family":"Etges","sequence":"first","affiliation":[{"name":"National Institute of Science and Technology for Health Technology Assessment (IATS)\u2014CNPq\/Brazil (project: 465518\/2014-1), Porto Alegre, Brazil"},{"name":"Graduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul School of Medicine, Porto Alegre, Brazil"},{"name":"Hospital de Cl\u00ednicas de Porto Alegre, Porto Alegre, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8407-0695","authenticated-orcid":true,"given":"Emanuela","family":"Pires","sequence":"additional","affiliation":[{"name":"National Institute of Science and Technology for Health Technology Assessment (IATS)\u2014CNPq\/Brazil (project: 465518\/2014-1), Porto Alegre, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0286-2822","authenticated-orcid":true,"given":"Caroline","family":"Pozza","sequence":"additional","affiliation":[{"name":"Hospital de Cl\u00ednicas de Porto Alegre, Porto Alegre, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5093-4739","authenticated-orcid":true,"given":"Patr\u00edcia","family":"Ashton-Prolla","sequence":"additional","affiliation":[{"name":"Hospital de Cl\u00ednicas de Porto Alegre, Porto Alegre, Brazil"},{"name":"National Institute of Science and Technology for Prevention and Precision Health in Oncogenetics\u2014(INCT Prev-Onco) CNPq\/Brazil, Porto Alegre, Brazil"},{"name":"Department of Genetics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3690-3987","authenticated-orcid":true,"given":"Claudia","family":"Astigarraga","sequence":"additional","affiliation":[{"name":"Hospital de Cl\u00ednicas de Porto Alegre, Porto Alegre, Brazil"},{"name":"Graduate Program in Clinical Medicine, Universidade Federal do Rio Grande do Sul School of Medicine, Porto Alegre, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2447-2577","authenticated-orcid":true,"given":"Carisi","family":"Polanczyk","sequence":"additional","affiliation":[{"name":"National Institute of Science and Technology for Health Technology Assessment (IATS)\u2014CNPq\/Brazil (project: 465518\/2014-1), Porto Alegre, Brazil"},{"name":"Graduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul School of Medicine, Porto Alegre, Brazil"},{"name":"Hospital de Cl\u00ednicas de Porto Alegre, Porto Alegre, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"233","reference":[{"key":"e_1_3_7_2_2","volume-title":"Protocolo Cl\u00ednico e Diretrizes Terap\u00eauticas da LMC em Adultos","author":"Brasil. 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Revista Brasileira de Hematologia e Hemoterapia 30:3-7, 2008","journal-title":"Revista Brasileira de Hematologia e Hemoterapia"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1080\/13696998.2018.1508023"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1080\/13696998.2017.1345750"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.japh.2017.01.004"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.23.01647"},{"key":"e_1_3_7_8_2","volume-title":"Avalia\u00e7\u00e3o dos Atrasos de Diagn\u00f3stico e Tratamento de Leucemias Nas Regi\u00f5es de Sa\u00fade do Rio Grande do Sul. Disserta\u00e7\u00e3o de Mestrado","author":"Rodrigues LT","year":"2021","unstructured":"Rodrigues LT: Avalia\u00e7\u00e3o dos Atrasos de Diagn\u00f3stico e Tratamento de Leucemias Nas Regi\u00f5es de Sa\u00fade do Rio Grande do Sul. Disserta\u00e7\u00e3o de Mestrado. 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