title: [Cost effectiveness of GM-CSF in the treatment of acute myeloblastic leukemia in aged patients: protocol of GOELAM Sa3].
abstract: A cost-effectiveness analysis was carried out from a randomized placebo-controlled protocol of GM-CSF during and after remission induction treatment for elderly patients with acute myeloid leukemia (AML). A retrospective economic analysis was carried out from the hospital perspective. A total of 240 patients with de novo AML and aged 55 to 75 years were enrolled. Overall survival and disease-free survival were analysed for efficacy within five years and expressed in gained life-years. Analysis was also conducted according to the protocol stratification: 55-64-year-old and 65-75-year-old patients. Global costs were estimated on the basis of patient medical records from inclusion to death or relapse. In all, 83 patients were evaluated from three centres, Besançon, Nancy and Nantes. Costs are expressed in French francs. Overall, total cost per patient amounted to FF 641,778 for placebo patients and to FF 587,048 for GM-CSF patients. For disease free-survival, costs were FF 357,167 for placebo patients and FF 320,736 for GM-CSF patients. For overall survival and disease free-survival the cost savings by GM-CSF were, respectively, FF 54,730 and FF 36,431. In the younger patient group savings were synonymous with GM-CSF. In all cases GM-CSF strategy induced benefit expressed as savings as well as efficacy.
authors.affiliation: Pharmacie, CHU Besançon, Bd Fleming, 25030 Besançon, France.
authors.forename: M C
authors.initials: MC
authors.lastname: Woronoff-Lemsi
authors.forename: F
authors.initials: F
authors.lastname: Witz
authors.forename: P
authors.initials: P
authors.lastname: Arveux
authors.forename: J Y
authors.initials: JY
authors.lastname: Cahn
authors.forename: J L
authors.initials: JL
authors.lastname: Harousseau
mesh_terms: D000368:Aged; D003362:Cost-Benefit Analysis; D018572:Disease-Free Survival; D005602:France; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000191:economics / Q000627:therapeutic use*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000191:economics / Q000401:mortality; D008875:Middle Aged; D010919:Placebos; D011994:Recombinant Proteins; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D010919:Placebos; D011994:Recombinant Proteins; D016178:Granulocyte-Macrophage Colony-Stimulating Factor