Study Shows G-CSF To Be Cost Effective

LONG BEACH, Calif--Using five key indicators of the severity ofillness to determine the cost effectiveness of growth factor use,researchers from Blue Cross of Western Pennsylvania found an averagecost ratio of about 1:7 for the use of G-CSF (filgrastim, Neupogen)in stage IV breast cancer patients undergoing high-dose chemotherapy/autologousbone marrow transplantation.

"For every dollar we spent on G-CSF, we saved $7 on inpatientcare," said Grant Lawless, MD, RPh, corporate medical directorand vice president of medical affairs. Speaking at the 1995 Qualityof Life symposium, sponsored by St. Mary Medical Center, Dr. Lawlessemphasized that "this is the simple kind of study we needto be doing to prove what we know instinctively to be true asoncologists."

Rather than looking at actual money spent per patient, Dr. Lawlessmeasured the consumption of health-care re- sources on a dailybasis, "because that allowed us to take into account thatpeople are less sick the last few days of treatment and requireless costly care."

Patients in the study who received purged bone marrow with G-CSFwere compared with those who received purged bone marrow withoutG-CSF, and those who received nonpurged bone marrow with G-CSFwere compared with those who received nonpurged bone marrow withoutG-CSF.

The five key indicators for comparison were total length of stay,days when absolute neutrophile count (ANC) was under 500, dayson growth factor, average days on antibiotics, and total cumulativeantibiotics days.

Dr. Lawless found that length of hospital stay fell by 20% inthe purged bone marrow group with use of G-CSF, and by 17% inthe nonpurged marrow group when G-CSF was given. The average numberof ANC days less than 500 fell by 23% in the purged marrow groupwith use of G-CSF, and by 35% in the nonpurged group with G-CSF.Finally, by using G-CSF, days of antibiotic use fell by 31% inthe purged marrow group and by 19% in the nonpurged marrow group.

With these findings, Dr. Lawless had no trouble justifying theuse of G-CSF to his company, "and it is now a regularly usedproduct in our area," he said.