Analysis of estimated clinical benefit of newly approved drugs for US patients with acute myeloid leukemia

Abstract

The increased number of available United States Food and Drug Administration (FDA)-approved drugs indicated for acute myeloid leukemia (AML) have generated considerable interest and may have the potential to influence practice. We performed a retrospective cross-sectional study performed from September to November 2019 to determine 1) demographic and subgroup characteristics of patients with newly diagnosed cases of acute myeloid leukemia, 2) FDA data on drugs indicated for AML approved from 1969 through November 2019, 3) measures of response from drug labels, and 4) published reports documenting the response for drugs approved before the 1979 Labeling Act. We used publicly available data from the Food and Drug Administration (FDA), the American Cancer Society, the Leukemia and Lymphoma Society, and the U.S. Census Bureau. According to our estimation methods, cytarabine infused continuously for 7 days, with three short boluses of anthracycline over Days 1-3, the standard of care known as "7 + 3", continues to have the largest population benefit. The maximum cost per course of treatment for an average regimen is enasidenib for salvage therapy, estimated to be around $120,131. The minimum cost was $1,662.50 for standard 7 + 3 chemotherapy. The mean and median cost for all AML treatments was $43,784.26 and $35,083.70, respectively. While it is true that the number of available therapies approved by the FDA has increased dramatically, it is not yet clear how large of a clinical benefit we can expect to see from these new lines of therapies.

Keywords: Acute myeloid leukemia; Chemotherapy; Drug costs.