Optimization of peripheral blood stem cell collection by leukopheresis - Interaction between economic and clinical assessment of an innovation

Using the example of substitution of peripheral blood stem cell (PBSC) coll ection to bone marrow harvest for autologous transplantation in cancer pati ents, our study attempts to illustrate how economic assessment, starling at an early stage of medical innovation, can influence the development and di ffusion process of a new technological procedure whose optimal design has n ot yet been established. Two cost minimization studies comparing costs for obtaining a clinically reinfusable graft using bone marrow harvest or alter natively various protocols of PBSC collection contributed to a change in th e French clinical standard for this procedure.