8 research outputs found
PMH58 The Impact of ADHD Medication Attributes on Physician Prescribing Behavior in the EU: Results From Chart-Reviewed Data
Methodological Assessment of Matching-Adjusted Indirect Comparisons: Case Study Application To Attention Deficit/Hyperactivity Disorder (Adhd)
Development of a conceptual disease model to inform strategy to evaluate treatment impact in adolescents with attention deficit hyperactivity disorder (ADHD)
Predicted effect size of lisdexamfetamine treatment of attention deficit/hyperactivity disorder (ADHD) in European adults: Estimates based on indirect analysis using a systematic review and meta-regression analysis
PMH65 Comparison of Deviation Rates from the Labeled Daily Average Consumption in Patients Initiated on Stimulant Medication for the Treatment of Attention-Deficit/Hyperactivity Disorder
PGI3 Validation of Algorithms to Identify Diverticulitis Through Electronic Medical Records in Kaiser Permanente Southern California (KPSC)
Economic analysis of a randomized clinical trial to compare filgrastim-mobilized peripheral-blood progenitor-cell transplantation and autologous bone marrow transplantation in patients with Hodgkin's and non-Hodgkin's lymphoma
Purpose: High-dose chemotherapy (HDC) with peripheral-blood progenitor cell (PBPC) and autologous bone marrow (ABM) transplant (T) has documented survival benefits for relapsed Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL). Treatment costs associated with HDC and its supportive care have restricted its use both on and off clinical trial. In a prospective randomized clinical trial, filgrastim-mobilized PBPCT resulted in faster recovery of bone marrow function, with less hospitalization and supportive care than ABMT. This study was undertaken to analyze the costs of the two strategies using prospectively collected data from a randomized clinical trial that compared filgrastim-mobilized PBPCT versus ABMT.
Patients and Methods: Clinical results and resource utilization from a randomized clinical trial that compared filgrastim-mobilized PBPCT versus ABMT following carmustine, etoposide, cytarabine, and melphalan (BEAM) HDC for HD and NHL are presented. The trial was performed in six centers in Germany, the United Kingdom, and Belgium. Resource utilization data were used to project costs and Massey Cancer Center (MCC) in the United States incurred the cost of treating the cohort. Costs were projected to the United Stares, because the economic implications to United States centers are significant, costs of care vary markedly among countries but resource utilization on this trial did not, and a randomized trial is unlikely to be performed in the United States.
Results: Fifty-eight patients with relapsed HD or NHL underwent HDC with BEAM. The PBPCT and ABMT groups had similar short-term survival after BEAM. PBPCT patients had a shorter hospitalization (median, 17 v 23 days; P = .002), neutrophil recovery (11 v 14 days; P = .005), platelet recovery to greater than or equal to 20 x 10(9)/L (16 v 23 days; P=.02), and days of platelet transfusions (6 v 10; P < .001). Estimated costs were 5,760 for PBPC collection, including filgrastim mobilization. The total estimated average cost was 45,792 for each PBPCT patient. Cost savings of $13,521 (23%) were due to shorter hospitalizations with less supportive care.
Conclusion: PBPCT is as safe and more effective than ABMT for HD and NHL in the short term. PBPCT represents a significant cost savings due to lower autograft collection costs, shorter hospital stays, and less supportive care. The savings exceed the costs for filgrastim mobilization and PBPC collection. Actual savings will vary depending on local practice patterns, charges, and costs. (C) 1997 by American Society of Clinical Oncology