Economic evaluation of 4% albumin solution, gelatine, and hydroxyethylamidon for plasma volume expansion in cancer patients

Abstract

Purpose. Given the potential advantages of the use of hydroxyethylamidon, the purpose of this cost analysis was to examine the economic consequences of the use of such derivatives compared to albumin and gelatine for fluid resuscitation in patients with various types of cancer. Methods. We report on the economic evalua tion conducted at the Montpellier Anticancer Center between July 1989 and December 1995. Patients with various types of cancer were included in the study. About 310 patients were treated each year. Since January 1991, an economic policy was undertaken to reduce the cost of treatment by volume expanders. Results. During the study period, the pharma ceutical price of these drugs, the number of patients, and the number of days of hospitalization remained relatively stable. From 1991 to 1995 of this economic evaluation, we observed a regular decrease in the utilization of fluid expanders. Indeed, 2370 vials were used in 1990 and only 868 in 1995. In 1991, a new plasma volume expander, hydroxyethylamidon, be came commercially available. Consequently, from 1992, we observed a decrease in the use of 4% albumin; then, from 1993, there was a decrease in the use of gelatine. In 1989, the mean cost of each vial was $46; it was $16 in 1995. This decrease is attrib utable to a progressive substitution of 4% albumin, then of gelatine, by hydroxyethylamidon. During the 24 first months of the present study, the total cost of plasma volume expanders was approximately $180,000 (July 1989 to June 1991); it was $164,000 during the following 54 months (July 1991 to Decem ber 1995). Conclusion. The pharmaceutical economic pol icy and the risk of using blood product have contrib uted to a decrease in the total cost of the different drugs used as plasma volume expanders. To date, the savings realized have been ∼$75,000 annually.