Prophylaxis of febrile neutropenia with colony-stimulating factors: the first 25 years

Edelsberg, John; Weycker, Derek; Bensink, Mark; Bowers, Charles; Lyman, Gary H.

doi:10.1080/03007995.2019.1703665

Cited by 17 publications

(17 citation statements)

References 87 publications

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“…L'uso di G-CSF nei pazienti con tumori solidi o neoplasie non mieloidi ha dimostrato di ridurre il rischio di ospedalizzazione, di morte e di riduzione dell'intensità della dose, migliorando allo stesso tempo la qualità di vita correlata alla chemioterapia somministrata (17,18).…”

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Budget impact analysis of pegfilgrastim biosimilar in the treatment of febrile neutropenia in Italy

Ravasio¹,

Antonuzzo

Danova³

et al. 2020

abtpn

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Introduction: Granulocyte-colony stimulating factors (G-CSFs) can significantly reduce the risk of febrile neutropenia (FN) among certain patients receiving chemotherapy. FN is associated with significant clinical and nonclinical complications. At present, the patent protection of pegfilgrastim (Neulasta®) has expired, and a biosimilar (Ziextenzo®) has been approved. Since the biosimilar price is expected to be lower as compared with the originator’s, the present Drug Budget Impact analysis tries to evaluate whether and how much profitable the biosimilar availability will be for the Italian NHS, in terms of cost containment (savings).Methods and Results: The model time horizon extends to five years. The initial overall number of treatments with pegfilgrastim is estimated based on the number of pegfilgrastim packages (assuming a recommended dose of 6 mg is administered after each cytotoxic chemotherapy) and kept constant in time. The model assumes that, year by year, the number of treatments with the originator will partly switch to the biosimilar (according to an uptake rate assumed). The results show that the availability of the biosimilar would provide an €6.4 million cumulated savings to the NHS in the five years.Conclusions: According to the present analysis, the availability of the biosimilar would generate cumulated savings (in five years) as high as €6.4 million for the Italian NHS. (HTA & Market Access)

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Budget impact analysis of pegfilgrastim biosimilar in the treatment of febrile neutropenia in Italy

Ravasio¹,

Antonuzzo

Danova³

et al. 2020

abtpn

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“…[17][18][19] Indeed, the use of G-CSFs in clinical practice, as primary and secondary prophylaxes, is driven by various factors including the convenience and cost of G-CSFs, availability of biosimilars and the clinical evidence for the benefit of G-CSFs. 14 A better understanding of the factors that influence the choice of G-CSF will allow optimisation of G-CSF use in clinical practice and consequently improve FN management in patients with cancer .…”

Section: What Are the New Findings?mentioning

confidence: 99%

“…There are several reasons for the inappropriate and inconsistent prescription of G-CSF. 14 The costeffectiveness of G-CSF used as primary and secondary prophylaxes remains controversial.…”

Section: Primary Prophylaxis Preferencementioning

confidence: 99%

Febrile neutropenia prophylaxis, G-CSF physician preferences: discrete-choice experiment

Scotté

Simon

Laplaige

et al. 2021

BMJ Support Palliat Care

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ObjectivesFebrile neutropenia (FN) commonly occurs during cancer chemotherapy. Prophylaxis with granulocyte colony-stimulating factors (G-CSFs) is known to reduce the severity and incidence of FN and infections in patients with cancer. Despite the proven efficacy, G-CSFs are not always prescribed as recommended. We performed a discrete-choice experiment (DCE) to determine what factors drive the physician preference for FN prophylaxis in patients with cancer undergoing chemotherapy.MethodsAttributes for the DCE were selected based on literature search and on expert focus group discussions and comprised pain at the injection site, presence of bone pain, associated fever/influenza syndrome, efficacy of prophylaxis, biosimilar availability, number of injections per chemotherapy cycle and cost. Oncologists, in a national database, were solicited to participate in an online DCE. The study collected the responses to the choice scenarios, the oncologist characteristics and their usual prescriptions of G-CSFs in the context of breast, lungs and gastrointestinal cancers.ResultsOverall, the responses from 205 physicians were analysed. The physicians were mainly male (61%), with ≤20 years of experience (76%) and working only in public hospitals (73%). The physicians prescribe G-CSF primary prophylaxis for 32% of patients: filgrastim in 46% and pegfilgrastim in 54%. The choice of G-CSF for primary and secondary prophylaxis was driven by cost and number of injections. Biosimilars were well accepted.ConclusionCost and convenience of G-CSF drive the physician decision to prescribe or not G-CSF for primary and secondary FN prophylaxes. It is important that these results be incorporated in the optimisation of G-CSF prescription in the clinical setting.

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“…Keeping high risk patients at home was a very effective and may be the most effective strategy in keeping patients safe. Furthermore, we utilized measures with proven benefit such as primary prophylaxis with CSF [26] and oral antibacterial medications to minimize patients coming in to the hospital with neutropenic sepsis. There were 324 episodes with neutropenia and 30% of those ended up with neutropenic sepsis but with no mortality.…”

Section: Plos Onementioning

confidence: 99%

Blood cancer care in a resource limited setting during the Covid-19 outbreak; a single center experience from Sri Lanka

et al. 2021

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Background The Covid-19 pandemic has caused significant morbidity and mortality among patients with cancer. Most countries employed measures to prevent spread of Covid-19 infection which include shielding, quarantine, lockdown, travel restrictions, physical distancing and the use of personal protective equipment. This study was carried out to assess the change in patient attendance and the efficacy of newly implemented strategies to mitigate the impact of Covid-19 on services at the Lanka Hospital Blood Cancer Centre (LHBCC) in Colombo, Sri Lanka. Methodology Telephone consultation, infection control, personal protective measures and emergency admission policy were implemented with the aim of having a Covid-19 free ward and to prevent cross-infections. This descriptive cross-sectional study was conducted with 1399 patient episodes (in-patient care or day-case review). We analysed patients treated as in-patient as well as day-case basis between 01st April 2020 and 31st December 2020. Results There were 977 day-case based episodes and 422 in-patient based episodes. There was a 14% drop in episode numbers compared to same period in 2019. There was no cross infection and no patients with Covid-19 related symptoms or positive test results entered the LHBCC during the study period. Conclusion Services in blood cancer care were maintained to prevent late stage presentation and adverse outcome. Measures implemented to prevent Covid-19 were effective to allow continuation of treatment. This study highlights the importance of implementing strict protocols, clinical screening, use of appropriate personal protective equipment in delivering blood cancer care during the Covid-19 pandemic. This is the only documented study relating to outcome and successful applicability of measures to prevent spread of Covid-19 infection and maintaining services among blood cancer patients in Sri Lanka.

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Prophylaxis of febrile neutropenia with colony-stimulating factors: the first 25 years

Cited by 17 publications

References 87 publications

Budget impact analysis of pegfilgrastim biosimilar in the treatment of febrile neutropenia in Italy

Budget impact analysis of pegfilgrastim biosimilar in the treatment of febrile neutropenia in Italy

Febrile neutropenia prophylaxis, G-CSF physician preferences: discrete-choice experiment

Blood cancer care in a resource limited setting during the Covid-19 outbreak; a single center experience from Sri Lanka

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