Cost-benefit analysis of granulocyte colony-stimulating factor in the management of elderly cancer patients.

Journal Article (Journal Article;Review)

Health care costs continue to rise, and hospitalization represents the single largest component of direct medical costs associated with cancer care. Neutropenia and its complications including febrile neutropenia (FN) remain the major dose-limiting toxicity of systemic cancer chemotherapy. The risk of FN varies considerably across treatment regimens but appears to be significantly higher among elderly patients. The colony-stimulating factors (CSFs) have been used effectively in a variety of clinical settings to prevent or treat FN and to assist patients receiving dose-intensive chemotherapy with or without stem cell support. Several randomized controlled trials (RCTs) have demonstrated the clinical efficacy of the prophylactic use of CSFs. A recently presented meta-analysis of the available RCTs has confirmed the efficacy of prophylactic CSFs. The cost of these agents, along with their large-scale clinical use, has prompted a number of economic investigations. Economic models based on measures of resource utilization derived from RCTs have provided FN risk threshold estimates for the cost-saving use of prophylactic CSF. A number of important studies concerning the clinical and economic impact of these agents in elderly cancer patients have been reported during the past year. Continuing clinical and economic evaluation along with an updating of clinical practice guidelines especially related to elderly patients is recommended because of rapid technologic and clinical advances.

Full Text

Duke Authors

Cited Authors

  • Lyman, GH; Kuderer, NM; Balducci, L

Published Date

  • May 2002

Published In

Volume / Issue

  • 9 / 3

Start / End Page

  • 207 - 214

PubMed ID

  • 11953666

International Standard Serial Number (ISSN)

  • 1065-6251

Digital Object Identifier (DOI)

  • 10.1097/00062752-200205000-00006


  • eng

Conference Location

  • United States