Analysis of the gap in PCR monitoring availability for patients with chronic myeloid leukemia in 60 low- and middle-income countries
| Autor: | Jerald P. Radich, Irina Usherenko, Pat Garcia-Gonzalez, Ann Kim Novakowski, Joseph B. Babigumira, Seth S. Rowley |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
0303 health sciences
lcsh:R5-920 Health economics South asia business.industry Research Health Policy Treatment outcome Health services research Myeloid leukemia Discontinuation 03 medical and health sciences 0302 clinical medicine Clinical research Low and middle income countries 030220 oncology & carcinogenesis Environmental health Medicine business lcsh:Medicine (General) 030304 developmental biology |
| Zdroj: | Cost Effectiveness and Resource Allocation, Vol 19, Iss 1, Pp 1-8 (2021) Cost Effectiveness and Resource Allocation : C/E |
| ISSN: | 1478-7547 |
| Popis: | Purpose To estimate the resource gap in the polymerase chain reaction (PCR) monitoring for patients with chronic myeloid leukemia (CML) in low- and middle-income countries (LMICs). Methods We developed a model of demand and supply of PCR monitoring of CML patients in 60 LMICs. PCR testing was assumed to use Cepheid’s GeneXpert® IV system. We included costs of GeneXpert® instruments, uninterrupted power supplies, warranties, calibration kits, test cartridges, and shipping. We calculated the country-specific monetary gap in PCR monitoring, stratified by country priority defined as the availability of tyrosine kinase inhibitors (TKIs) through The Max Foundation initiatives. Results The 5-year gap in PCR monitoring was $29.1 million across all countries, 22% ($6.4 million) in countries with all five TKIs available, 20% ($5.7 million) in countries with four TKIs available, 50% ($14.5 million) in countries with three TKIs available, 8% ($2.2 million) in countries with two TKIs available, and 1% ($0.3 million) in countries with one TKI available. The gap was highest in South Asia (52%; $15.1 million) and lowest in Latin America (6%; $1.9 million). Excluding labor costs, the bulk of the resource needs (86%; $25.2 million) were for procurement of BCR-ABL cartridges. Conclusion Removing the 5-year gap in PCR monitoring capacity for CML in LMICs will require the mobilization of significant resources and will likely lead to better treatment outcomes and reduced treatment costs through optimization of treatment, discontinuation of therapy in appropriate patients, and facilitation of clinical research. Development of streamlined monitoring guidelines for resource-limited countries should be considered. |
| Databáze: | OpenAIRE |
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