PERIPHERAL-BLOOD PROGENITOR-CELL TRANSPLANTATION FOR BREAST-CANCER - PHARMACOECONOMIC CONSIDERATIONS

The recent observation that mobilized peripheral blood progenitor cell s (PBPCs) can be used as a source of hematopoietic support has had a m ajor effect on the cost and morbidity associated with bone marrow tran splantation in patients with breast cancer. The pharmacoeconomic impac t of this new technology is especially evident when secondary costs ar e analyzed. We see a reduction in hospital stay decreased use of resou rces such as platelet transfusions and antibiotics, and long-term qual ity life-years gained for those patients benefiting from this therapy. Experienced transplant centers have found that the direct cost of hig h-dose chemotherapy using filgrastim and PBPC support is reduced as mu ch as 50% to the patient or their insurance company. Pharmacists will play a key role in optimizing the benefits of PBPC transplantation, pa rticularly because this therapy is moving to the outpatient arena. Thi s article will review the pharmacoeconomic impact of PBPC transplantat ion primarily in terms of secondary cost measures and quality of life and discuss the limited direct cost data available and the impact of t his therapy on pharmacy practice.