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Economic Study

Economic analysis of a phase III study of G-CSF vs placebo following allogeneic blood stem cell transplantation

Bone Marrow Transplantation volume 26, pages 663–666 (2000)Cite this article

Abstract

Hematopoietic colony-stimulating factors (CSF) decrease the duration of neutropenia following stem cell transplantation (SCT). With CSF-mobilized allogeneic blood SCT (alloBSCT), the yields of CD34+ cells are several-fold higher than in other SCT settings, raising concern that post-transplant CSF use may be unnecessary. In this study, we estimate the resource and cost implications associated with CSF use following alloBSCT. A cost identification analysis was conducted for 44 patients on a randomized, double-blind placebo-controlled trial of G-CSF following alloBSCT. Study drug was given daily until an absolute neutrophil count (ANC) ⩾1000 cells/μl. Billing information from the time of transplant to day +100 was analyzed. The median number of days to an ANC ⩾500 cells/μl was shorter in the G-CSF arm, 10.5 days vs 15 days (P < 0.001), while platelet recovery and rates of acute graft-versus-host disease (gvhd) and survival were similar. resource use was similar, including days hospitalized, days on antibiotics, blood products transfused and outpatient visits. total median post-transplant costs were $76 577 for g-csf patients and $78 799 for placebo patients (P = 0.93). G-CSF following allogeneic blood SCT decreased the median duration of absolute neutropenia and did not incur additional costs, but did not result in shorter hospitalizations, or less frequent antibiotic use. Bone Marrow Transplantation (2000) 26, 663–666.

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Acknowledgements

We are indebted to James Armitage MD, Dean of the University of Nebraska Medical School and Susan Quinn of the University of Nebraska Medical Center for their assistance and guidance.

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Authors and Affiliations

  1. Division of Hematology/Oncology, Northwestern University, Chicago, IL, USA

    TJ Stinson, JR Adams & CL Bennett

  2. Department of Internal Medicine, Section of Oncology and Hematology, University of Nebraska Medical Center, Omaha, NE, USA

    MR Bishop, S Kruse & S Tarantolo

  3. Department of Experimental Transplantation and Immunology, National Cancer Institute, Bethesda, MD, USA

    MR Bishop

  4. Robert H Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA

    CL Bennett

  5. Chicago VA Health Care System-Lakeside Division, Chicago, IL, USA

    CL Bennett

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  1. TJ Stinson
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Stinson, T., Adams, J., Bishop, M. et al. Economic analysis of a phase III study of G-CSF vs placebo following allogeneic blood stem cell transplantation. Bone Marrow Transplant 26, 663–666 (2000). https://doi.org/10.1038/sj.bmt.1702579

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