PHARMACOECONOMICS

PBSC tr'ampIantation + tiIgrastim improves heahh outcomes

Transplantation of peripheral blood stem cells (PBSC) followed by filgrastim therapy leads to better outcomes and greater cost savings than other interventions for patients with metastatic breast cancer, says Dr Grant Lawless from the healthcare payer Blue Cross, Western Pennsylvania, US.

Study researchers reviewed the medical charts of 58 patients with metastatic breast cancer who had undergone autologous bone marrow transplantation (BMT) at a US hospital between November 1989 and July 1993.

Patients received one of the following treatment regimens: bone marrow purged, no filgrastim (n = 8); bone marrow not purged, no filgrastim (6); bone marrow purged + filgrastim following autologous BMT (9); bone marrow not purged + filgrastim following autologous BMT (20); or PBSC transplantation followed by filgrastim (15).

FiIgrastim reducei resource consumption Health outcomes were significantly improved

among filgrastim recipients, compared with nonrecipients [see table].

Notably, duration of hospital stay, the number of days with an absolute neutrophil count < 500 cells/mm3 and duration of antimicrobial use were lowest among patients undergoing PBSC transplantation + filgrastim.

Furthermore, this treatment group had significantly fewer days' filgrastim therapy, compared with those

whose bone marrow was purged and who received filgrastim following autologous BMT.

Use of PBSC transplantation + filgrastim therapy has reduced autologous BMT costs to Blue Cross by > 50% since 1990, notes Dr Lawless. Lawless GD. Cost-effectiveness of autologous bone marrow tranSplantation.

American Journal of Health-System Pharmacy 52 (SuppL 4): 11-14.1 Oct 1995

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INPHARMA- 4 Nov 1995