Hematopoietic stem cell transplantation (HSCT) plays a critical role in the management of acute lymphoblastic leukemia (ALL). In the era of tyrosine kinase inhibitors (TKIs) and their evolution from first to third generation, patients with ALL may attain complete responses and delay or avoid HSCT. The objective of this study is to assess the clinic-economic impacts of delayed or avoided HSCT in the treatment of patients with newly diagnosed (ND) Philadelphia chromosome-positive (Ph+) ALL receiving first-line ponatinib versus generic imatinib over a three-year time horizon from a US Commercial health plan perspective.