Drugs & Aging

, Volume 20, Issue 7, pp 479–483

Cost Analyses Of Adjunct Colony Stimulating Factors For Older Patients With Acute Myeloid Leukaemia

Can they Improve Clinical Decision Making?

Authors

    • Chicago VA Healthcare System/Lakeside DivisionMidwest Center for Health Services and Policy Research
    • Robert H Lurie Comprehensive Cancer Center
    • Division of Hematology/Oncology of the Department of MedicineNorthwestern University
  • Glen T. Schumock
    • Department of Pharmacy Practice, Center for Pharmacoeconomic ResearchUniversity of Illinois at Chicago
Leading Article

DOI: 10.2165/00002512-200320070-00001

Cite this article as:
Bennett, C.L. & Schumock, G.T. Drugs Aging (2003) 20: 479. doi:10.2165/00002512-200320070-00001
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Abstract

Colony stimulating factors (CSF) have been shown to reduce the duration of neutropenia following intensive chemotherapy in a variety of settings, with many of these studies targeting older patients with leukaemia. We review the clinical and economic findings for use of growth factors for older adults with acute myelogenous leukaemia (AML). The cost analyses were based on the perspective of the third party payer. One study, conducted by the Southwest Oncology Group (SWOG) randomised 207 AML patients to receive granulocyte colony-stimulating factor (G-CSF) or placebo and found no significant difference in number of infections and in days of hospitalisation, 3 fewer days with an absolute neutrophil count <500 cells/μL with G-CSF, and an estimated incremental cost of only $US120 with G-CSF over placebo (1997 costs). A second study, conducted by the Eastern Cooperative Oncology Group (ECOG), randomised 119 AML patients to receive granulocyte-macrophage colony-stimulating factor (GM-CSF) or placebo and found a reduction in severe infections, 4 fewer days with an absolute neutrophil count <500 cells/μL, no significant difference in the duration of hospitalisation, and estimated cost savings of $US2310 with GM-CSF (1997 costs). These data may be useful to physicians faced with concerns over clinical and economic factors associated with CSF use as adjunct therapy for older persons with AML.

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