Search

OBJECTIVE: To assess the cost-effectiveness of weekly compared to monthly white blood count (WBC) monitoring in patients with severe granulomatosis with polyangiitis (GPA) receiving oral cyclophosphamide (CYC). METHODS: The two CBC monitoring approaches for surveillance of leukopenia and its consequences were compared using a decision analysis model. The prevalence of leukopenia, infections, and outcomes were obtained from an existing registry and published reports. Costs were in dollars (2010) and effectiveness as quality-adjusted life-years (QALYs) gained.RESULTS: The expected utility of weekly CBC monitoring of these patients for leukopenia is 18.74 QALYs versus 18.52 QALYs with monthly CBC. The expected gain is 0.22 QALYs and incurs $489 lower cost per patient. The weekly CBC strategy mostly dominated the monthly CBC strategy. CONCLUSION: Weekly CBC monitoring is cost-effective for prevention of severe leukopenia and severe infections in patients on CYC for severe GPA.