title: Costo- Efectividad Del Uso Profiláctico Del Factor Estimulante De Colonias De Granulocitos En Adultos Con Leucemia Linfoblástica Aguda en Colombia.
abstract: OBJECTIVE
  To assess the cost-effectiveness of prophylactic administration of Granulocyte Colony-Stimulating Factor (G-CSF) compared with no use of it, during the induction phase of chemotherapy in Adults with Acute Lymphoblastic Leukemia (ALL) in Colombia.
  
  
  METHODS
  A decision tree with a time horizon of 30 days was built under colombian health system perspective including only direct costs. The costs of procedures and medications were taken from official sources and an institution of national reference of oncology services. The safety and effectiveness data were taken from the literature and two Colombian cohorts with patients older than 15 years. The unit of outcome was the proportion of deaths avoided.
  
  
  RESULTS
  Base-case results on a clinical trial indicate that using factor is a dominant strategy. The variable that most impacted the outcome was the incidence of febrile neutropenia. Considering a threshold of $22.228 USD in 80% of cases using factor was cost effective. However, the use of factor is not cost-effective for the country for incidences of febrile neutropenia > 48%. It was not possible to establish cost-effectiveness of pegfilgrastim because no information was found.
  
  
  CONCLUSIONS
  As per Colombian data, the use of prophylactic factor under chemotherapeutic induction in adults with ALL, turns out to be not cost effective. The difference in the results suggests the need of a careful extrapolation of information from clinical trials (ideal world) for developing economic evaluations in Colombia.
authors.affiliation: Centro Dermatológico Federico Lleras Acosta E.S.E., Bogotá D. C., Colombia. Electronic address: casavieja2032@gmail.com.
authors.forename: Elkin Javier
authors.initials: EJ
authors.lastname: Casadiego Rincón
authors.affiliation: Universidad Nacional de Colombia, Bogotá D. C., Colombia.
authors.forename: Jorge Augusto
authors.initials: JA
authors.lastname: Díaz Rojas
authors.affiliation: Instituto Nacional de Cancerología, Bogotá D, C., Colombia.
authors.forename: Carlos Daniel
authors.initials: CD
authors.lastname: Bermúdez
authors.affiliation: Universidad Nacional de Colombia, Bogotá D. C., Colombia.
authors.forename: Víctor Prieto
authors.initials: VP
authors.lastname: Martínez
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003105:Colombia; D003362:Cost-Benefit Analysis; D000069585:Filgrastim / Q000191:economics* / Q000627:therapeutic use; D006801:Humans; D009503:Neutropenia / Q000188:drug therapy* / Q000209:etiology; D011092:Polyethylene Glycols; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*
chemical_list: D000970:Antineoplastic Agents; D011092:Polyethylene Glycols; D000069585:Filgrastim
keywords: Colombia; Cost- Effectiveness Analysis; Febrile Neutropenia; Filgrastim; Granulocyte Colony-Stimulating Factor; Leukemia; Pegfilgrastim