PEGASPARGASE VERSUS ASPARAGINASE IN ADULT ALL - A PHARMACOECONOMIC ASSESSMENT

Asparaginase is an effective treatment for patients with acute lymphoc ytic leukemia (ALL). Unfortunately, asparaginase therapy is associated with a high incidence of hypersensitivity reactions (up to 73%), incl uding life-threatening anaphylaxis, and its half-life of approximately 20 hours necessitates daily administration. Pegaspargase, a modificat ion of L-asparaginase, has a longer half-life (357 hours), a decreased incidence of hypersensitivity reactions, and when dosed every 14 days , provides comparable efficacy to asparaginase; however, it is much mo re expensive per single-dose vial ($980.00 vs $52.38), To determine th e pharmacoeconomic impact of the two agents, we conducted a cost-minim ization analysis for three common adult ALL protocols. Results showed. that pegaspargase was significantly less costly to payers on an inpat ient or outpatient basis and warranted addition to our formulary.