Richard T. Silver, MD, Professor of Medicine, Director, Leukemia and Myleoproliferative Center, New York Presbyterian-Weill Cornell Medical Center, comments on the cost of drugs to treat chronic myeloid leukemia (CML).

Overall, Silver believes that the cost of drugs to treat CML is too high. Additionally, in the majority of patients, he remains unconvinced that other agents work as well as imatinib, which will soon be off patent.

To select the most appropriate treatment, it remains important for a physician to discuss costs as well as risk factors with a patient. Silver notes that in general, he prescribes imatinib to approximately two-thirds of his patients with CML and will continue to do so, specifically as a generic version becomes available.

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Richard T. Silver, MD, from the New York Presbyterian-Weill Cornell Medical Center, comments on the cost of drugs to treat chronic myeloid leukemia.

Dr. Richard Silver Discusses the High Cost of Drugs in CML

Richard T. Silver, MD, Professor of Medicine, Director, Leukemia and Myleoproliferative Center, New York Presbyterian-Weill Cornell Medical Center, discusses the use hydroxyurea and interferons in myeloproliferative neoplasms (MPNs).

The most commonly used drug in MPNs, Silver says, is hydroxyurea. There is no biologic basis for its use as it just kills cells indiscriminately. In addition, hydroxyurea is taken orally and presents significant side effects including nausea and vomiting.

The new use of interferon was shaped by the fact that doses were previously too high: side effects were too great and the agent was never promoted. Interferon has shown efficacy in chronic hepatitis with lower doses, causing a renewed interest in the hematologic space.

Richard T. Silver, MD, Professor of Medicine, Director, Leukemia and Myleoproliferative Center, New York Presbyterian-Weill Cornell Medical Center, discusses the use hydroxyurea and interferons in myeloproliferative neoplasms.

Dr. Silver on Hydroxyurea and Interferon in MPNs

Richard T. Silver, MD, Professor of Medicine, Director, Leukemia and Myleoproliferative Center, New York Presbyterian-Weill Cornell Medical Center, discusses the use of interferons in myeloproliferative neoplasms (MPNs).

Silver says that the thought to use interferon in MPNs such as essential thrombocythemia stemmed from its activity against hematopoietic cells. In patients with polycythemia vera, interferon has demonstrated long term remission. In patients with essential thrombocythemia, 80-90% response rates have been observed. Silver says that interferon can be used in women who are pregnant, bringing down platelet count, without leukomogenic or teratogenic qualities that would affect the fetus, unlike hydroxyurea.

Richard T. Silver, MD, Professor of Medicine, Director, Leukemia and Myleoproliferative Center, New York Presbyterian-Weill Cornell Medical Center, discusses the use of interferons in myeloproliferative neoplasms.

Richard T. Silver, MD

Articles

Dr. Richard Silver Discusses the High Cost of Drugs in CML

Dr. Silver on Hydroxyurea and Interferon in MPNs

Dr. Richard T. Silver Discusses the Use of Interferons in MPNs