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Cost savings and luteinizing hormone-releasing hormone agonist.

In the March 2006 issue of the Journal of Oncology Practice, Wagmiller et al1 describe significant potential cost savings for use of an individualized luteinizing hormone-releasing hormone agonist (LH-RHa) strategy based on serum testosterone triggers rather than strict manufacturer guidelines. It is clear and well documented that gonadal suppression persists for months after LH-RHa therapy is held, and even minimal androgen recovery may be delayed by more than 12 months after longer than 2 years of continuous therapy. Given the substantial economic impact and preliminary suggestion of a noninferior outcome, efforts to define the real world savings should be evaluated prospectively.