10 INTERNATIONAL RESEARCH & OPINION

GM-CSF favoured post-BMT ... Recombinant granulocyte-macrophage colony­

stimulating factor [GM-CSF; sargramostim] is associated with a substantial decrease in the use and cost of initial hospital services following bone marrow transplantation, compared with placebo, according to a US double-blind study.

Patients with acute lymphoblastic leukaemia, non-Hodgkin'S lymphoma or Hodgkin's disease who underwent autologous bone marrow transplantation (BMT) were randomised to receive IV sargramostim* 250 )lg/m2 (n = 22) or placebo (18). Both treat­ments were administered by 2-hour infusion on successive days from day 0 (the day of BMT) to day 20.

Hospital chatges 21 % lower with GM-CSF Mean initial hospital charges were $US54 100

and $68 600 for sargramostim and placebo recipients, respectively. These costs included room and IV medication charges (antibacterials and hyper­alimentation) which were $5300 and $5000 lower, respectively, in the sargramostim, compared with the placebo, group.

Pharmacy charges were $2700 more for sargramostim-treated patients; this is likely to be a result of the predicted cost of sargramostim ($160/500)lg t). Also, the duration of initial hospitali­sation was 6.6 days shorter among sargramostim, compared with placebo, recipients (24.2 vs 30.8 days, respectively). However, there was no difference in subsequent hospitalisations during the first 100 days post-BMT, report the investigators. Outpatient charges during this period were $9500 and $6800 for the sargramostim and placebo groups, respectively. Overall, total in- and outpatient charges were $12200 lower for sargramostim-treated patients compared with the placebo group.

The comparison of net changes in healthcare costs attributable to the use of new technologies, such as sargramostim, is a concern for patients, healthcare providers and third-party payers, the investigators point out. They believe that 'the net cost to the hospital for the initial inpatient stay may play an important role in the acceptance of this therapy'. * Immunex®; supplied by Hoechst Roussel Pharmaceuticals

t This estimate was the same as the subsequent marketed price.

Luce BR, Singer JW, Weschler IM, Buckner CD, Sheingold SH, et aI. Recombinant human granulocyte-macrophage colony-stimulating factor after autologous bone marrow transplantation for lymphoid cancer: an economic analysis of a randomised, double-blind, placebo-controlled trial. PharmacoEconomics 6: 42-48, Jul 1994 ""'''''''

20 Aug 1994 PHARMACORESOURCES'" 1172-829919410011-000101$01.00° Adlslnternatlonal limited 1994. All rights reunred