title: Pegaspargase versus asparaginase in adult ALL: a pharmacoeconomic assessment.
abstract: Asparaginase is an effective treatment for patients with acute lymphocytic leukemia (ALL). Unfortunately, asparaginase therapy is associated with a high incidence of hypersensitivity reactions (up to 73%), including life-threatening anaphylaxis, and its half-life of approximately 20 hours necessitates daily administration. Pegaspargase, a modification of L-asparaginase, has a longer half-life (357 hours), a decreased incidence of hypersensitivity reactions, and when doses every 14 days, provides comparable efficacy to asparaginase; however, it is much more expensive per single-dose vial ($980.00 vs $52.38). To determine the pharmacoeconomic impact of the two agents, we conducted a cost-minimization analysis for three common adult ALL protocols. Results showed that pegaspargase was significantly less costly to payers on an inpatient or outpatient basis and warranted addition to our formulary.
authors.affiliation: Saint Louis University Hospital, St. Louis, MO 63110, USA.
authors.forename: B G
authors.initials: BG
authors.lastname: Peters
authors.forename: B J
authors.initials: BJ
authors.lastname: Goeckner
authors.forename: J J
authors.initials: JJ
authors.lastname: Ponzillo
authors.forename: W S
authors.initials: WS
authors.lastname: Velasquez
authors.forename: A L
authors.initials: AL
authors.lastname: Wilson
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000191:economics; D000970:Antineoplastic Agents / Q000191:economics* / Q000627:therapeutic use; D001215:Asparaginase / Q000008:administration & dosage / Q000191:economics* / Q000493:pharmacokinetics / Q000627:therapeutic use; D002985:Clinical Protocols; D016527:Drug Costs / Q000706:statistics & numerical data*; D004342:Drug Hypersensitivity; D006207:Half-Life; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008923:Missouri; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000191:economics* / Q000493:pharmacokinetics / Q000627:therapeutic use; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000191:economics*