ECONOMIC-EVALUATION OF G-CSF IN CANCER-THERAPY - 2 EXAMPLES OF FRENCHSTUDIES

The paper presents two recent examples of <<cost-minimization>> studie s, carried out in the French context, about the use of an haemopoietic growth factor (G-CSF(1)) in patients receiving cytotoxic chemotherapy or autologous bone marrow transplantation. The aim of such studies is to estimate the extent to which cost savings associated with the redu ced incidence of severe neutropenia events and infection in patients r eceiving G-CSF partially or totally offset the direct extra costs of t his drug. The two studies illustrate different methodological approach es for empirical economic assessment with respective advantages and dr awbacks: one which is based on the adaptation to the French situation of the results of international randomized clinical trials; the other one which compares detailed observation of medical costs in samples of patients treated in one centre (Institut Paoli-Calmettes-Marseille). Both studies confirm that net extra costs of therapeutic strategies us ing G-CF are very limited (or even nil) in comparison with strategies which do not. They also confirm the sensitivity of this result to hypo theses concerning daily costs of hospitalization and a priori risks of neutropenia. Future economic appraisal of indications for G-CSF (or o ther HGF's) treatment will require other types of analysis (<<cost-eff ectiveness>> or <<cost-utility>> analyses) that are better suited to t rue comparison of the performance of different therapeutic strategies, taking into account both clinical results and the use of ressources.