Christian Chabannon, MD, PhD, from Institut Paoli Calmettes, Marseille, France, discusses the pharmacoeconomic aspects of mobilization at the 2017 annual meeting of the European Society for Blood and Marrow Transplantation (EBMT) in Marseille, France. He explains that one of the questions in mobilization is whether or not to use the first of its class new medication plerixafor. According to Prof. Charbannon, this is characterized by its high price tag, thereby introducing a financial aspect to whether or not it should be used together with other drugs during mobilization of stem cells to collect for future transplants. He explains that at EBMT, he presented a detailed analysis of all costs associated with mobilization and collection procedures, and also determined that parts of the cost of plerixafor can be offset by decreased use of other drugs. He highlights the importance of this, as a high proportion of patients who are candidates for high-dose chemotherapy supported by autologous stem cell transplantation behave as poor mobilizers, meaning that the number of circulating stem cells does not substantially increase in response to conventional mobilization agents. Prof. Chabannon describes that consequently, it can be difficult to collect a good quality graft and so several apheresis sessions may be needed to collect circulating stem cells. While this is not a very invasive procedure, it can take between 3 and 5 hours, and repeating this over several days alters the quality of life of patients and creates additional constraints.
