The economic evaluation of hematopoietic growth factors in high-dose chemotherapy

Hematopoietic growth factors (HGFs) such as granulocyte colony stimulating factor or granulocyte macrophage colony stimulating factor have been shown to accelerate engraftment after transplantation and facilitate peripheral blood stem cells mobilization. Besides efficacy and safety, the economic impact of these expensive new drugs produced via biotechnological methods is of major concern. The use of HGFs in high-dose chemotherapy (HDC) therefore requires that economic evaluation starts as early as possible throughout the R&D. This can participate in the innovation development process and help predict subsequent diffusion of the technology over time, and potential evolution in expected clinical utilization and costs. Although some issues about the economic consequences of their use have been determined by 'piggyback' studies (economic evaluation alongside randomized controlled trials), several questions remain unanswered regarding the costs involved in therapeutic innovations permitted by the use of HGFs in HDC.