Patient adherence and persistence with Imatinib, Nilotinib, Dasatinib in clinical practice

• Published in: PloS one Vol. 8; no. 2; p. e56813
• Main Authors: Santoleri, Fiorenzo, Sorice, Paola, Lasala, Ruggero, Rizzo, Rosa Carmela, Costantini, Alberto
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 20-02-2013; Public Library of Science (PLoS)
• Subjects: Adhesion; Adolescent; Adult; Aged; Aged, 80 and over; Antineoplastic agents; Benzamides - administration & dosage; Calendars; Cancer; Chemotherapy; Clinical medicine; Dasatinib; Dosage; Drug dosages; Drug stores; Female; Hospitals; Humans; Imatinib; Imatinib Mesylate; Leukemia; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - drug therapy; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - mortality; Male; Medical personnel; Medical research; Medication Adherence; Medicine; Middle Aged; Oncology; Pathology; Patient compliance; Patients; Pharmacists; Physicians; Piperazines - administration & dosage; Prescription drugs; Pyrimidines - administration & dosage; Studies; Therapy; Thiazoles - administration & dosage; Time Factors; Treatment Outcome; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0056813

The aim of this study is to evaluate adherence and persistence of patients treated with Imatinib, Nilotinib or Dasatinib, also giving economic evaluations on therapy costs for Received Daily Dose (RDD).
In this retrospective study, we took into account 3 years from 1st Jan. 2009 to 31st March.2012. Treatment adherence was quantified utilizing ratio between RDD and PDD (Prescribed Daily Dose). Persistence is reckoned taking into account the actual therapy days, comparing posology with supplied dose, drawing the graph using Kaplan-Meir method.
Adherence results in values between 0.8 and 1.0 for Nilotinib (Adh  = 0.93), Imatinib (Adh  = 0.83) and Dasatinib (0.85). Imatinib has better persistence, 90% of patients in treatment exceed one year of treatment versus 83.3% for Nilotinib and 80% for Dasatinib. The cost per single day of treatment (cost per RDD) was € 39.41 for Imatinib, € 113.60 for Nilotinib and € 94.84 for Dasatinib.
Patients with CML have a loose of adherence both in first line with Imatinib and in second line of therapy with Dasatinib and Nilotinib. Loss of adherence remains a big problem and could be minimized by a patient-oriented project invlolving physicians, nurses, pharmacists and caregiver.