Impact of plerixafor (mozobil) on hospital efficiency: A single center experience

Abstract

Plerixafor (Mozobil) in combination with granulocyte colony-stimulating factor (G-CSF) has shown to increase mobilization of peripheral blood stem cells (PBSC) as compared to G-CSF alone in patients undergoing autologous stem cell transplantation (ASCT). However, up to 25% of patients treated with G-CSF alone still fail mobilization. Adding plerixafor to poor mobilizers allows to rescue these patients from mobilization failure and to reduce the number of apheresis sessions. The goal of this retrospective study was to capture the impact of plerixafor on treatment outcome and on apheresis department efficiency. The latter was measured in terms of time-slots lost, that is, the number of apheresis sessions scheduled but not carried out due to poor mobilization, and the number of elective apheresis sessions performed for patients undergoing extracorporeal photopheresis (ECP). Hospital records of patients treated before and after introduction of plerixafor were collected and analyzed. With plerixafor, the mobilization failure rate dropped from 12% to 4% and the mean number of time-slots lost per patient dropped from 1.39 to 0.89. Additional drug costs due to plerixafor were partially balanced by a reduction in apheresis sessions, resulting in an additional cost of 759€ per ASCT candidate. More importantly, with the use of plerixafor, the availability of time-slots turned from erratic to predictable such that freed capacity could be dedicated to other apheresis procedures. As a result, the number of ECP sessions increased from 0 in 2005 to 685 sessions in 2014.

A transition from using multi‐step procedures to a fully integrated system for performing extracorporeal photopheresis: A comparison of costs and efficiencies

“…Previous studies within our department reported that the use of plerixafor to aid peripheral blood stem cell mobilization in patients undergoing autologous stem cell transplantation reduced the mean number of apheresis time‐slots lost per patient from 1.39 to 0.89 and increased the predictability of available time‐slots . This allowed the department to dedicate resources for ECP procedures.…”

Plerixafor in poor mobilizers with non-Hodgkin’s lymphoma: a multi-center time-motion analysis

“…Studies adopting a wider perspective which captures additional costs incurred to the hospital due to mobilization failure (e.g. delay in treatment, disruption of patient flow, inability to proceed to transplantation) have shown that plerixafor improves the use of apheresis capacities and may even be cost-saving [18,22,27]. Here, a narrow perspective was selected on purpose to decrease the institution-specific variations and to increase the generalizability of our results.…”

“…Plerixafor may also rescue patients from mobilization failure in case of poor mobilization in response to G-CSF only [15][16][17]. Several cost-effectiveness studies have shown that plerixafor, when given to poor mobilizers, decreased mobilization failure rates at an acceptable increase in costs for patients with MM and NHL [13,[18][19][20]. A direct comparison between studies is hampered because of differences in the ASCT procedure and local guidelines, health care provision, and reimbursement.…”

Mozobil® (Plerixafor, AMD3100), 10 years after its approval by the US Food and Drug Administration

“…24 While 25% of patients treated with G-CSF alone still failed mobilization, upon the addition of plerixafor, the failure rate would drop to 4%. 25…”