LONG BEACH, Calif--Using five key indicators of the severity of illness to determine the cost effectiveness of growth factor use, researchers from Blue Cross of Western Pennsylvania found an average cost ratio of about 1:7 for the use of G-CSF (filgrastim, Neupogen) in stage IV breast cancer patients undergoing high-dose chemotherapy/autologous bone marrow transplantation.
"For every dollar we spent on G-CSF, we saved $7 on inpatient care," said Grant Lawless, MD, RPh, corporate medical director and vice president of medical affairs. Speaking at the 1995 Quality of Life symposium, sponsored by St. Mary Medical Center, Dr. Lawless emphasized that "this is the simple kind of study we need to be doing to prove what we know instinctively to be true as oncologists."
Rather than looking at actual money spent per patient, Dr. Lawless measured the consumption of health-care re- sources on a daily basis, "because that allowed us to take into account that people are less sick the last few days of treatment and require less costly care."
Patients in the study who received purged bone marrow with G-CSF were compared with those who received purged bone marrow without G-CSF, and those who received nonpurged bone marrow with G-CSF were compared with those who received nonpurged bone marrow without G-CSF.
The five key indicators for comparison were total length of stay, days when absolute neutrophile count (ANC) was under 500, days on growth factor, average days on antibiotics, and total cumulative antibiotics days.
Dr. Lawless found that length of hospital stay fell by 20% in the purged bone marrow group with use of G-CSF, and by 17% in the nonpurged marrow group when G-CSF was given. The average number of ANC days less than 500 fell by 23% in the purged marrow group with use of G-CSF, and by 35% in the nonpurged group with G-CSF. Finally, by using G-CSF, days of antibiotic use fell by 31% in the purged marrow group and by 19% in the nonpurged marrow group.
With these findings, Dr. Lawless had no trouble justifying the use of G-CSF to his company, "and it is now a regularly used product in our area," he said.