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Supportive Care in Cancer
Published in: Supportive Care in Cancer 2/2011

01-02-2011 | Original Article

Impact of changes in reimbursement policies and institutional practice algorithm for utilization of erythropoietic-stimulating agents on treatment patterns and costs in anemic lymphoma patients

Authors: Lincy Subha Lal, Aditya Raju, Lesley-Ann Miller, Hua Chen, Rebecca Arbuckle, Sujit S. Sansgiry

Published in: Supportive Care in Cancer | Issue 2/2011

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Abstract

Purpose

The objective of this study was to assess the impact of a new evidence-based institutional practice algorithm on the patterns and costs of treatment of chemotherapy-induced anemia (CIA) in lymphoma patients prescribed erythropoietic-stimulating agents (ESAs).

Methods

The study design was retrospective, with a historical control group. Patient demographic data, clinical data (including chemotherapy and hemoglobin values), and cost data were extracted from patient medical charts and institutional databases. Descriptive statistics, t tests, and chi-square analyses were conducted to evaluate the study objectives.

Results

The study population consisted of 154 patients, 90 patients in the pre-implementation group and 64 in the post-implementation group. Both groups had similar demographic and baseline clinical characteristics. After implementation, there was a significant decrease in the mean hemoglobin level at the time of subsequent ESA dosing from 9.59 to 8.98 g/dL (P < 0.0001). The proportion of patients who received an ESA at a hemoglobin level >10 g/dL decreased significantly from 66% to 17% (P < 0.0001). There was no significant difference in the mean hemoglobin level at week 4 of ESA therapy, which may indicate that patients were not clinically affected by the change in practice. There were also no significant differences in the number of transfusions administered associated with the treatment of CIA in the study population.

Conclusions

The results of the study show an association between implementation of the new institutional practice algorithm for ESA usage in CIA and a change in ESA utilization patterns.
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Metadata
Title
Impact of changes in reimbursement policies and institutional practice algorithm for utilization of erythropoietic-stimulating agents on treatment patterns and costs in anemic lymphoma patients
Authors
Lincy Subha Lal
Aditya Raju
Lesley-Ann Miller
Hua Chen
Rebecca Arbuckle
Sujit S. Sansgiry
Publication date
01-02-2011
Publisher
Springer-Verlag
Published in
Supportive Care in Cancer / Issue 2/2011
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-009-0811-3

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