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Research Articles |
OBJECTIVE: To compare the cost of recombinant human erythropoietin (rHuEPO) with that of blood transfusion in the treatment of chemotherapy-induced anemia from a healthcare system perspective. DESIGN: A decision analytic model. Baseline estimates were obtained from a review of clinical trials data and economic evaluation studies. SUBJECTS: Secondary data analyses of patients with advanced malignancies, excluding hematologic malignancies and metastasized solid tumors. INTERVENTIONS: Patients received either leukocyte-depleted packed red blood cells (PRBCs) or rHuEPO 150 units/kg s.c. three times per week for 6 months (24 wk). After 6 weeks, if rHuEPO recipients did not display a response, they received rHuEPO 300 units/kg s.c. three times weekly for the duration of therapy. If rHuEPO recipients still exhibited no response, they were given blood transfusions. MEASUREMENTS AND MAIN RESULTS: For a treatment period of 24 weeks, approximately 64% of rHuEPO recipients responded at an average expected cost of $12971 per patient. One hundred percent of transfusion recipients responded at a cost of $481; this resulted in a cost savings of $8490. Variation of response rates for rHuEPO or PRBCs did not appreciably lower costs. Lower rHuEPO dosages and higher numbers of transfused units of PRBCs yielded approximately equivalent costs; however, these strategies may not be clinically prudent. CONCLUSIONS: From a healthcare system cost and outcome perspective, blood transfusion is the preferred strategy for chemotherapy-induced anemia. However, rHuEPO may be considered an effective blood-sparing alternative for patients with non-stem cell disorders. Future cost-effectiveness analyses are needed to assess more completely both the clinical and quality-of-life benefits rHuEPO may contribute to individual patients' lives and to society overall.
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  D. Cella, D. Dobrez, and J. Glaspy Control of cancer-related anemia with erythropoietic agents: a review of evidence for improved quality of life and clinical outcomes Ann. Onc., April 1, 2003; 14(4): 511 - 519. [Abstract] [Full Text] [PDF]
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 P.-Y. Cremieux, B. Barrett, K. Anderson, and M. B. Slavin Cost of Outpatient Blood Transfusion in Cancer Patients J. Clin. Oncol., July 14, 2000; 18(14): 2755 - 2761. [Abstract] [Full Text] [PDF]
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