Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
7
pubmed:dateCreated
2007-6-20
pubmed:abstractText
A double-blind, randomized trial showed that, compared with placebo, palifermin (recombinant human keratinocyte growth factor) reduced the frequency and duration of oral mucositis in patients with hematologic malignancies undergoing high-dose chemotherapy and total-body irradiation with autologous stem-cell support. This previously published study also showed a significant reduction in the incidence of adverse subsequent outcomes. The objective of this study was to estimate the impact of palifermin prophylaxis on hospital costs of transplantation in the trial. This was a retrospective, economic analysis of estimated costs for a previously published clinical trial. Costs were not collected during the trial. Therefore, we estimated the direct medical costs of hospitalization using hospital charges from similar patients' hospitalization charges selected from the National Inpatient Sample, a population-based, nationally representative sample of hospital claims. Costs were estimated from charges using Medicare's state-specific cost-to-charge ratios. These cost estimates were applied to the outcome data (incidence of febrile neutropenia, bacteremia/fungemia, or pneumonia, and use of total parenteral nutrition) from the clinical trial. Patients were those with hematologic malignancies who received high-dose chemotherapy and total-body irradiation with autologous stem cell transplant. We compared the estimated total hospital costs (in 2005 United States dollars) incurred by patients who received palifermin in the clinical trial with those incurred by patients who received placebo. Costs were analyzed from the provider's perspective. The mean cost of a hospital day in this population varied between $2,834, when no adverse outcomes occurred, and $4,663, when all 4 outcomes occurred. Reductions in adverse outcomes and their associated hospital stay offset the acquisition price of palifermin. A nonsignificant mean savings of $3,595 per patient (95% confidence interval: $2,090-$5,103) was observed. In sensitivity analyses, this observation was robust to all plausible values of per diem hospital costs and hypothetic per diem outpatient costs. In addition to its previously demonstrated clinical benefit, palifermin prophylaxis offers a favorable economic profile among patients with hematologic malignancies who receive total body irradiation and autologous stem cell support.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Jul
pubmed:issn
1083-8791
pubmed:author
pubmed:issnType
Print
pubmed:volume
13
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
806-13
pubmed:meshHeading
pubmed-meshheading:17580258-Adult, pubmed-meshheading:17580258-Clinical Trials, Phase III as Topic, pubmed-meshheading:17580258-Costs and Cost Analysis, pubmed-meshheading:17580258-Double-Blind Method, pubmed-meshheading:17580258-Female, pubmed-meshheading:17580258-Fibroblast Growth Factor 7, pubmed-meshheading:17580258-Hematologic Neoplasms, pubmed-meshheading:17580258-Hematopoietic Stem Cell Transplantation, pubmed-meshheading:17580258-Hospitalization, pubmed-meshheading:17580258-Humans, pubmed-meshheading:17580258-Male, pubmed-meshheading:17580258-Medicare, pubmed-meshheading:17580258-Middle Aged, pubmed-meshheading:17580258-Randomized Controlled Trials as Topic, pubmed-meshheading:17580258-Stomatitis, pubmed-meshheading:17580258-Transplantation, Autologous, pubmed-meshheading:17580258-United States, pubmed-meshheading:17580258-Whole-Body Irradiation
pubmed:year
2007
pubmed:articleTitle
Economic impact of palifermin on the costs of hospitalization for autologous hematopoietic stem-cell transplant: analysis of phase 3 trial results.
pubmed:affiliation
Health Services Research, Department of Biostatistics, University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030-4009, USA. lelting@mdanderson.org <lelting@mdanderson.org>
pubmed:publicationType
Journal Article, Comparative Study, Research Support, Non-U.S. Gov't, Multicenter Study