NEUTROPENIA AND NEOPLASIA - AN OVERVIEW OF THE PHARMACOECONOMICS OF SARGRAMOSTIM IN CANCER-THERAPY

Sargramostim is a myeloid growth factor that is widely used as adjunct ive support in patients with neutropenia. Sargramostim enhances neutro phil recovery and myeloid engraftment, reduces infectious complication s, and shortens the duration of hospitalization in selected patients. The high cost of sargramostim and other myeloid growth factors and the ir ability to reduce infections and days of hospitalization have gener ated interest in their pharmacoeconomic impact. Cost minimization stud ies in patients receiving chemotherapy for acute myelogenous leukemia and in recipients of autologous bone marrow transplantation (BMT) show estimated cost savings with sargramostim of 1996 US$12,513 and 1994 U S$14,500, respectively. These data are consistent with cost savings of 1989 US$16,000 using molgramostim in autologous BMT recipients. Altho ugh no pharmacoeconomic data have been published in patients with othe r conditions, clinical outcomes research demonstrates a clear benefit for sargramostim administration in recipients of peripheral blood prog enitor cell and allogeneic BMT and in patients who experience graft de lay or failure. Because of reductions in the duration of hospitalizati on and infectious complications, economic outcomes of these conditions would probably also support sargramostim use. More data regarding the use of sargramostim for chemotherapy-induced neutropenia are required to properly assess the pharmacoeconomic impact in these patients.