title: Evaluating the use of plerixafor in stem cell mobilisation - an economic analysis of the PHANTASTIC trial.
abstract: Plerixafor is an effective haematopoietic stem cell mobilising agent in candidates for autologous transplantation, including patients with myeloma and lymphoma. Here we compare 98 plerixafor recipients in the PHANTASTIC trial with 151 historic controls mobilised by conventional chemotherapy (each with granulocyte colony-stimulating factor, G-CSF). Seventy (71.4%) plerixafor-mobilised patients achieved the composite primary endpoint of ≥4 × 10(6) CD34+ cells kg(-1) in ≤2 aphereses and no clinically significant neutropenia, compared to 48 (31.8%) historic controls (P < 0.001), and this significant advantage was maintained in scenario analyses testing components of this composite endpoint. A patient-level cost analysis was undertaken for 249 patients, which included the cost of remobilising patients where initial mobilisation had failed. Combined mean treatment cost for plerixafor mobilised patients was £12,679 compared with £11,694 for historical controls. However, plerixafor produces an average saving of £3,828 per lymphoma patient but average cost increase by £5,245 per myeloma patient. The present data demonstrate cost-effectiveness for plerixafor as a first line mobilisation agent, certainly for lymphoma patients, where substantial resource savings and achievement of the primary endpoint are likely. J. Clin. Apheresis 31:434-442, 2016. © 2015 Wiley Periodicals, Inc.
authors.affiliation: Liverpool Health Economics, Department of Economics, University of Liverpool Management School, Liverpool, United Kingdom. apmartin@liv.ac.uk.
authors.forename: Antony P
authors.initials: AP
authors.lastname: Martin
authors.affiliation: Liverpool Health Economics, Department of Economics, University of Liverpool Management School, Liverpool, United Kingdom.
authors.forename: Sarah
authors.initials: S
authors.lastname: Richards
authors.affiliation: Liverpool Health Economics, Department of Economics, University of Liverpool Management School, Liverpool, United Kingdom.
authors.forename: Alan
authors.initials: A
authors.lastname: Haycox
authors.affiliation: Liverpool Health Economics, Department of Economics, University of Liverpool Management School, Liverpool, United Kingdom.
authors.forename: Rachel
authors.initials: R
authors.lastname: Houten
authors.affiliation: Liverpool Health Economics, Department of Economics, University of Liverpool Management School, Liverpool, United Kingdom.
authors.forename: Claire
authors.initials: C
authors.lastname: McLeod
authors.affiliation: Haematology Department, Royal Liverpool University Hospital, Liverpool, United Kingdom.
authors.forename: Barbara
authors.initials: B
authors.lastname: Braithwaite
authors.affiliation: Haematology Department, Royal Liverpool University Hospital, Liverpool, United Kingdom.
authors.forename: Jack O
authors.initials: JO
authors.lastname: Clark
authors.affiliation: Haematology Department, Royal Liverpool University Hospital, Liverpool, United Kingdom.
authors.forename: Joanne
authors.initials: J
authors.lastname: Bell
authors.affiliation: Haematology Department, Royal Liverpool University Hospital, Liverpool, United Kingdom.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Clark
mesh_terms: D001596:Benzylamines; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D000080027:Cyclams; D016179:Granulocyte Colony-Stimulating Factor / Q000191:economics / Q000627:therapeutic use; D019650:Hematopoietic Stem Cell Mobilization / Q000191:economics / Q000379:methods*; D006571:Heterocyclic Compounds / Q000191:economics / Q000627:therapeutic use*; D065386:Historically Controlled Study; D006801:Humans; D008223:Lymphoma / Q000191:economics / Q000628:therapy; D009101:Multiple Myeloma / Q000191:economics / Q000628:therapy
chemical_list: D001596:Benzylamines; D000080027:Cyclams; D006571:Heterocyclic Compounds; D016179:Granulocyte Colony-Stimulating Factor; C088327:plerixafor
keywords: haematology; lymphoma; myeloma; stem cell mobilisation; stem cell transplantation