[A descriptive study of erythropoietin use and cost in hematologic patients].
OBJECTIVE
To assess the effectiveness of erythropoietin use in hematologic patients; to analyze the extent to which recommendations are applied as provided by Spanish prescribing information, American Society of Clinical Oncology (ASCO) and American Society of Hematology (ASH) guidelines, as well as specific recommendations for myelodysplastic syndromes (MDSs), and to perform a descriptive analysis of costs.


METHODS
A descriptive retrospective study. Patient selection was performed by Unidad de Atención Farmacéutica a Pacientes Externos (UFPE: Pharmaceutical Outpatient Care Unit) during a 3-month period of time. Follow-up was performed to month 9 after selection.


RESULTS
Thirty-six patients (37% males) were included. In the group of patients with multiple myeloma and lymphomas, effectiveness was 57%; while in the MDS group it was 45-64% (depending on criteria used to measure erythroid response). Of all 24 patients (MDSs excluded) only 4 (17%) met indication criteria--adjustment to erythroid response at 4 and 8 weeks, and dosage titration when needed. Continued treatment with erythropoietin in all non-responders amounted to 59-69% of total expense for non-responders.


CONCLUSIONS
There is a high percentage of therapy failures and inconsistency between erythropoietin use recommendations and clinical practice. This circumstance, as well as the high financial impact it entails, makes it essential that monitoring and follow-up strategies are implemented to contribute to an optimal usage of erythropoiesis stimulating factors.
Pelufo Pellicer
A
A
Servicio de Farmacia, Hospital Universitario La Fe, Valencia, Spain. pelufo_ana@gva.es
Monte Boquet
E
E
Poveda Andrés
J L
JL
Cuéllar Monreal
M J
MJ
D000368:Aged; D000740:Anemia / Q000188:drug therapy* / Q000191:economics / Q000209:etiology / Q000628:therapy; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001803:Blood Transfusion / Q000191:economics / Q000706:statistics & numerical data; D003131:Combined Modality Therapy; D016527:Drug Costs; D004341:Drug Evaluation; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D004363:Drug Utilization / Q000706:statistics & numerical data; D004920:Erythropoiesis / Q000187:drug effects; D004921:Erythropoietin / Q000191:economics / Q000627:therapeutic use*; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D019983:Guideline Adherence; D019337:Hematologic Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000150:complications* / Q000191:economics; D017410:Practice Guidelines as Topic; D011994:Recombinant Proteins / Q000191:economics / Q000627:therapeutic use; D012189:Retrospective Studies; D013030:Spain; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D011994:Recombinant Proteins; D004921:Erythropoietin; D016179:Granulocyte Colony-Stimulating Factor