A cost analysis of hematopoietic colony-stimulating factors.
The administration of hematopoietic colony-stimulating factors (CSFs) to reduce the severity and duration of neutropenia associated with systemic chemotherapy has become widespread, although the appropriate use of these agents has not yet been fully defined. A cost model based on decision theory is presented for three therapeutic choices in these patients: no CSF, prophylactic CSF, and therapeutic CSF. Baseline probabilities were derived from a prospective, randomized, placebo-controlled trial of G-CSF in patients receiving systemic chemotherapy. Application of the model to institutionally generated cost figures provides comparative estimates of excess cost favoring the prophylactic use of CSFs. Model thresholds were calculated based on sensitivity analysis comparing no CSF to prophylactic CSF, and therapeutic CSF to prophylactic CSF. Guidelines are provided based on this model that are consistent with those adopted by the American Society of Clinical Oncology.
Lyman
G H
GH
Department of Internal Medicine, University of South Florida, College of Medicine, H. Lee Moffitt Cancer Center, Tampa, USA.
Balducci
L
L
D000970:Antineoplastic Agents / Q000009:adverse effects; D018288:Carcinoma, Small Cell / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D003115:Colony-Stimulating Factors / Q000191:economics* / Q000627:therapeutic use; D003365:Costs and Cost Analysis; D003661:Decision Support Techniques; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D009503:Neutropenia / Q000188:drug therapy* / Q000209:etiology; D011446:Prospective Studies; D015996:Survival Rate
D000970:Antineoplastic Agents; D003115:Colony-Stimulating Factors