title: Neutropenia and neoplasia: an overview of the pharmacoeconomics of sargramostim in cancer therapy.
abstract: Sargramostim is a myeloid growth factor that is widely used as adjunctive support in patients with neutropenia. Sargramostim enhances neutrophil recovery and myeloid engraftment, reduces infectious complications, and shortens the duration of hospitalization in selected patients. The high cost of sargramostim and other myeloid growth factors and their ability to reduce infections and days of hospitalization have generated interest in their pharmacoeconomic impact. Cost minimization studies in patients receiving chemotherapy for acute myelogenous leukemia and in recipients of autologous bone marrow transplantation (BMT) show estimated cost savings with sargramostim of 1996 US$12,513 and 1994 US$14,500, respectively. These data are consistent with cost savings of 1989 US$16,000 using molgramostim in autologous BMT recipients. Although no pharmacoeconomic data have been published in patients with other conditions, clinical outcomes research demonstrates a clear benefit for sargramostim administration in recipients of peripheral blood progenitor cell and allogeneic BMT and in patients who experience graft delay or failure. Because of reductions in the duration of hospitalization and infectious complications, economic outcomes of these conditions would probably also support sargramostim use. More data regarding the use of sargramostim for chemotherapy-induced neutropenia are required to properly assess the pharmacoeconomic impact in these patients.
authors.affiliation: Massey Cancer Center, Richmond, Virginia, USA.
authors.forename: C E
authors.initials: CE
authors.lastname: Desch
authors.forename: H
authors.initials: H
authors.lastname: Ozer
mesh_terms: D001424:Bacterial Infections / Q000150:complications; D016026:Bone Marrow Transplantation / Q000191:economics; D002986:Clinical Trials as Topic; D003362:Cost-Benefit Analysis; D017850:Economics, Pharmaceutical; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000627:therapeutic use*; D006801:Humans; D007902:Length of Stay / Q000191:economics; D015470:Leukemia, Myeloid, Acute / Q000191:economics; D009369:Neoplasms / Q000188:drug therapy* / Q000191:economics; D009503:Neutropenia / Q000150:complications / Q000188:drug therapy* / Q000191:economics; D009504:Neutrophils / Q000187:drug effects; D011994:Recombinant Proteins / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D011994:Recombinant Proteins; C081222:sargramostim; D016178:Granulocyte-Macrophage Colony-Stimulating Factor