Program: Oral and Poster Abstracts
Session: 902. Health Services and Outcomes Research – Malignant Diseases: Poster I
Adult patients aged ≥18 years, with a primary diagnosis of NHL, who underwent PBSC mobilization at 9 European centers in France, Germany and Italy were included in the study. Part I is a retrospective medical record review of 200 NHL patients. Outcomes measured in Part I included # of visits for administration of mobilizing agents and # days administered; assessment of adverse events (AEs) associated with administered mobilizing agents; # of apheresis sessions; hours of apheresis sessions; attainment of CD34+ target; and days until CD 34+ target level met. For Pre-P era patients, the peripheral CD-34+ count recorded immediately prior to the first apheresis; for P era patients, it was that recorded immediately prior to plerixafor administration. Part II is a prospective time and motion evaluation of apheresis performed at each center (5 events recorded per center; patient consent was obtained). Apheresis events were measured in consecutive patients scheduled to be candidates for PBSC mobilization. Time-motion assessments, obtained retrospectively (Part I) and prospectively (Part II), included total time to prepare the patient, perform apheresis and manage AEs. A micro-costing exercise was carried out by obtaining costs per unit of resource utilization from interviews with hospital administration staff. The study end points are the difference in mean time/effort to perform apheresis (including apheresis related AEs, if any) and total costs associated with mobilization to the hospital between patients in the Pre-P versus P eras.
Evaluation of patient demographics revealed no significant differences between pre-P and P era cohorts. Analysis of the number of apheresis sessions demonstrated a statistically significant reduction (P<0.001) for the P era group, including # of sessions, total blood volume collected and total apheresis time required to reach the targeted PBSC compared with Pre-P era group. Total cost differences between cohorts was estimated based on observed clinical and resource utilization differences. In addition, more than twice as many patients who had a CD 34+ <10 were mobilized in the P era compared with patients in the Pre-P era.
This study demonstrates that use of plexiafor is associated with statistically significant reductions in the # of apheresis sessions, driving both resource utilization efficiencies and cost savings for NHL patients undergoing autologous PBSC mobilization vs patients in the pre-P era. Further research to quantify the time and motion and cost-consequences of treatment approaches for stem cell mobilization in routine clinical care is warranted to optimize treatment for NHL patients.
Disclosures: Azar: Sanofi: Honoraria , Research Funding . Reitan: Amgen: Research Funding ; Sanofi: Research Funding ; Spectrum: Research Funding . Gallagher: Sanofi: Employment , Equity Ownership .
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