Cost‐effectiveness of granulocyte colony‐stimulating factor prophylaxis in chemotherapy‐induced febrile neutropenia among breast cancer and Non‐Hodgkin's lymphoma patients under Taiwan's national health insurance system

Wen, Tsun Jen; Wen, Yue; Chien, Chun Ru; Chiang, Shu Chiung; Hsu, William Wei Yuan; Shen, Li‐Jiuan; Hsiao, Fei‐Yuan

doi:10.1111/jep.12597

Cited by 4 publications

(2 citation statements)

References 28 publications

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“…Our findings that primary prophylaxis is cost-effective in patients with breast cancer are consistent with previous studies [ 19 – 21 , 44 , 45 ]. For example, a previous study conducted in Taiwan evaluated the cost-effectiveness of short-acting G-CSFs in breast cancer patients and found that primary prophylaxis was cost-effective and secondary prophylaxis was a dominated strategy [ 45 ]. While the previous study only evaluated the cost-effectiveness of short-acting G-CSFs, our study further incorporated long-acting G-CSF and biosimilars into the evaluation.…”

Section: Discussionsupporting

confidence: 93%

Cost-effectiveness analysis of granulocyte colony-stimulating factors for the prophylaxis of chemotherapy-induced febrile neutropenia in patients with breast cancer in Taiwan

Tseng,

Chiang,

Hsu

et al. 2024

PLoS ONE

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Objectives To examine the cost-effectiveness of using granulocyte colony-stimulating factor (G-CSF) for primary or secondary prophylaxis in patients with breast cancer from the perspective of Taiwan’s National Health Insurance Administration. Methods A Markov model was constructed to simulate the events that may occur during and after a high-risk chemotherapy treatment. Various G-CSF prophylaxis strategies and medications were compared in the model. Effectiveness data were derived from the literature and an analysis of the National Health Insurance Research Database (NHIRD). Cost data were obtained from a published NHIRD study, and health utility values were also obtained from the literature. Sensitivity analyses were performed to assess the uncertainty of the cost-effectiveness results. Results In the base-case analysis, primary prophylaxis with pegfilgrastim had an incremental cost-effectiveness ratio (ICER) of NT$269,683 per quality-adjusted life year (QALY) gained compared to primary prophylaxis with lenograstim. The ICER for primary prophylaxis with lenograstim versus no G-CSF prophylaxis was NT$61,995 per QALY gained. The results were most sensitive to variations in relative risk of febrile neutropenia (FN) for pegfilgrastim versus no G-CSF prophylaxis. Furthermore, in the probabilistic sensitivity analysis, at a willingness-to-pay threshold of one times Taiwan’s gross domestic product per capita, the probability of being cost-effective was 88.1% for primary prophylaxis with pegfilgrastim. Conclusions Our study suggests that primary prophylaxis with either short- or long-acting G-CSF could be considered cost-effective for FN prevention in breast cancer patients receiving high-risk regimens.

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Section: Discussionsupporting

confidence: 93%

Cost-effectiveness analysis of granulocyte colony-stimulating factors for the prophylaxis of chemotherapy-induced febrile neutropenia in patients with breast cancer in Taiwan

Tseng,

Chiang,

Hsu

et al. 2024

PLoS ONE

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“…A study using Taiwan's NHI database showed positive effectiveness and cost-effectiveness results for primary prophylactic use of G-CSF in patients with non-Hodgkin's lymphoma. Primary prophylactic G-CSF was not only effective in preventing neutropenia with a 74% reduction in incidence, but also reduced the incidence of febrile neutropenia by 83% at an incremental cost of US$52 per cycle to reduce 1% of febrile neutropenia [45]. From the perspective of Taiwan's healthcare payers, the incremental cost-effectiveness ratio was well below the willingness to pay (WTP) threshold of three times Taiwan's 2015 gross domestic product per capita (US$22,464) [46,47].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness and Safety of Originator and Biosimilar G-CSF as Primary Prophylaxis in DLBCL: A Cohort Study and Meta-Analysis

Kang,

Lee,

Wang

et al. 2023

Preprint

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Background Real-world data on the comparative use of originator and biosimilar granulocyte colony-stimulating factors (G-CSF) in Asia is lacking. This study aimed to compare the effectiveness and safety of originator and biosimilar G-CSF as primary prophylaxis in patients with diffuse large B-cell lymphoma (DLBCL).Methods This cohort study evaluated patients with previously untreated DLBCL who received chemotherapy and primary prophylactic G-CSF. We assessed the incidence of febrile neutropenia, severe neutropenia, post-chemotherapy nadir absolute neutrophil count (ANC), infection, and adverse events (AEs) in patients receiving biosimilar G-CSF compared to those receiving originator G-CSF. Inverse probability weighting and logistic/linear regression were used. Additionally, a systematic review and meta-analyses were performed to compare febrile neutropenia incidence.Results We included 146 patients (65 years, 58% female). The majority (92%) received short-acting G-CSF; 35 patients received a biosimilar. There was no significant difference between biosimilar and originator G-CSF in febrile neutropenia (adjusted odds ratio: 0.31, 95% CI: 0.06, 1.61), infection (0.79; 0.23, 2.77) and severe neutropenia (0.21; 0.04, 1.11). Biosimilar G-CSF was associated with increased post-chemotherapy ANC (β: 1176.30, SE: 495.27, p: 0.019). None experienced an AE leading to G-CSF withdrawal or death. The results of the meta-analyses indicated comparable effectiveness between the short-acting biosimilar and the originator (1.03; 0.73, 1.44), but the long-acting originator G-CSF exhibited a superior effect (1.73; 1.24, 2.43).Conclusions Short-acting biosimilar G-CSF was as effective as originator G-CSF in preventing febrile neutropenia, whereas long-acting originator G-CSF may provide better protection. These results informed decision-making and formulary policies.

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Impact of primary prophylaxis by pegfilgrastim in diffuse large B-cell lymphoma treated with R-CHOP

Kim,

Ahn,

Ahn

et al. 2023

Ann Hematol

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Cost‐effectiveness of granulocyte colony‐stimulating factor prophylaxis in chemotherapy‐induced febrile neutropenia among breast cancer and Non‐Hodgkin's lymphoma patients under Taiwan's national health insurance system

Abstract: Primary but not secondary prophylactic use of G-CSF was cost-effective in CIFN in breast cancer and NHL patients under Taiwan's NHI system.

Cited by 4 publications

References 28 publications

Cost-effectiveness analysis of granulocyte colony-stimulating factors for the prophylaxis of chemotherapy-induced febrile neutropenia in patients with breast cancer in Taiwan

Cost-effectiveness analysis of granulocyte colony-stimulating factors for the prophylaxis of chemotherapy-induced febrile neutropenia in patients with breast cancer in Taiwan

Effectiveness and Safety of Originator and Biosimilar G-CSF as Primary Prophylaxis in DLBCL: A Cohort Study and Meta-Analysis

Impact of primary prophylaxis by pegfilgrastim in diffuse large B-cell lymphoma treated with R-CHOP

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