Background: Chronic myeloid leukaemia (CML) is a haematological malignant disease involving haematopoietic stem cells. It is caused by a known reciprocal chromosomal t(9;22)(q34;q11) translocation, or known as Philadelphia chromosome. The translocation results in the formation of a chimeric BCR-ABL fusion gene. In the most recent guidelines published by NCCN and European LeukemiaNet in 2013, tyrosine kinase inhibitors (TKI) specifically inhibiting the Bcr-Abl tyrosine kinase, are the first-line therapy for patients with chronic phase CML. Imatinib is the oldest among the 3 TKI, and is the most commonly prescribed. Despite its proven therapeutic role in CML, imatinib is a drug of extreme high cost. Estimated annual drug cost is HKD223,380forastandard400mgadultdailydose.Therefore,thisstudyaimstosurveyontheprescribingpatternofimatinibinCMLpatients,itsfundingstatus,response;andestimateitseconomicburdenontheHongKongpopulation.Methodology:Thisisaretrospectivepatientchartreviewstudy.AllpatientswhowerediagnosedwithCMLfrom2003to2012andweremanagedinQMHorQEHwerereviewed.Electronicrecordswereretrievedtoseewhetherimatinibwasstartedasfirst−linetreatmentwithin6monthsofdiagnosis.Thereasonsfornotinitiatingimatinibwerealsoinvestigated.Patients’responsetoimatinib,andfundingsourceforthedrug,weredocumented.AnnualdrugcostofimatinibwasestimatedfromallCMLpatientswhoattendedallHospitalAuthorityinstitutionsin2012whowereprescribedwiththedrug.Results:Total153patientsfromthe2institutionswerereviewed.Onehundredtwentyfour(81113,902. The estimated annual cost burden on the whole Hong Kong population is HK$43,425,878.
Conclusion: The prescribing rate of imatinib in chronic phase CML patients in Hong Kong is comparable to overseas prescribing rate. The drug has become a significant financial burden to patients’ family and the society as a whole.published_or_final_versionPaediatrics and Adolescent MedicineMasterMaster of Medical Science