Cost-minimization analysis of prophylactic granulocyte colony-stimulating factor after induction chemotherapy in children with non-Hodgkin's lymphoma.
BACKGROUND
Colony-stimulating factors promote the proliferation of certain bone marrow cell populations. The primary objective of treating patients with these factors prophylactically following chemotherapy is to reduce the risk of infection, thereby minimizing the need for hospitalization and parenteral antibiotics. The use of colony-stimulating factors in children is widespread, despite the absence of conclusive supportive data and the high cost of these drugs. Consequently, the cost-benefit ratio of using prophylactic colony-stimulating factors is an important issue in cancer therapy.


METHODS
During the period from January 1994 through June 1996, 149 afebrile children with newly diagnosed non-Hodgkin's lymphoma were randomly assigned either to receive granulocyte colony-stimulating factor (G-CSF) (lenograstim; 5 microg/kg body weight per day subcutaneously) or not to receive it (the control) at the end of the first two courses of induction chemotherapy with cyclophosphamide, vincristine, prednisone, doxorubicin, and methotrexate. A cost-minimization analysis was performed to assess the cost of chemotherapy in each group and to quantify how much could be economized by prescribing G-CSF.


RESULTS
The total cost for induction chemotherapy was $29,765 in the G-CSF-treated group and $30,774 in the control group, indicating that the treatment strategy with G-CSF was slightly less expensive than the strategy without G-CSF (mean difference = $1009; 95% confidence interval = -$1474 to $3492).


CONCLUSIONS
Treatment with G-CSF following chemotherapy in children with non-Hodgkin's lymphoma--previously shown to be of limited clinical benefit--also does not appear to reduce the costs of chemotherapy.
Rubino
C
C
Département de Biostatistique et d'Epidémiologie, Institut Gustave Roussy, Villejuif, France.
Laplanche
A
A
Patte
C
C
Michon
J
J
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000191:economics*; D002648:Child; D002675:Child, Preschool; D003363:Cost Control; D003362:Cost-Benefit Analysis; D005602:France; D016179:Granulocyte Colony-Stimulating Factor / Q000191:economics* / Q000627:therapeutic use*; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000191:economics*; D009503:Neutropenia / Q000139:chemically induced / Q000191:economics* / Q000628:therapy*; D012074:Remission Induction; D016896:Treatment Outcome
D016179:Granulocyte Colony-Stimulating Factor