Primary Prophylaxis With Biosimilar Filgrastim for Patients at Intermediate Risk for Febrile Neutropenia: A Cost-Effectiveness Analysis
| Autor: | Kim Campbell, Edward C. Li, Dylan Mezzio, David Campbell, Gary H. Lyman |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Lung Neoplasms Filgrastim Coronavirus disease 2019 (COVID-19) Cost-Benefit Analysis Polyethylene Glycols 03 medical and health sciences 0302 clinical medicine Carcinoma Non-Small-Cell Lung Granulocyte Colony-Stimulating Factor medicine Humans 030212 general & internal medicine Intensive care medicine Biosimilar Pharmaceuticals health care economics and organizations Febrile Neutropenia SARS-CoV-2 Oncology (nursing) business.industry Health Policy COVID-19 Cancer Biosimilar Guideline Cost-effectiveness analysis medicine.disease Oncology 030220 oncology & carcinogenesis Intermediate risk business Febrile neutropenia medicine.drug |
| Zdroj: | JCO Oncology Practice. 17:e1235-e1245 |
| ISSN: | 2688-1535 2688-1527 |
| DOI: | 10.1200/op.20.01047 |
| Popis: | PURPOSE: Temporary COVID-19 guideline recommendations have recently been issued to expand the use of colony-stimulating factors in patients with cancer with intermediate to high risk for febrile neutropenia (FN). We evaluated the cost-effectiveness of primary prophylaxis (PP) with biosimilar filgrastim-sndz in patients with intermediate risk of FN compared with secondary prophylaxis (SP) over three different cancer types. METHODS: A Markov decision analytic model was constructed from the US payer perspective over a lifetime horizon to evaluate PP versus SP in patients with breast cancer, non–small-cell lung cancer (NSCLC), and non-Hodgkin lymphoma (NHL). Cost-effectiveness was evaluated over a range of willingness-to-pay thresholds for incremental cost per FN avoided, life year gained, and quality-adjusted life year (QALY) gained. Sensitivity analyses evaluated uncertainty. RESULTS: Compared with SP, PP provided an additional 0.102-0.144 LYs and 0.065-0.130 QALYs. The incremental cost-effectiveness ranged from $5,660 in US dollars (USD) to $20,806 USD per FN event avoided, $5,123 to $31,077 USD per life year gained, and $7,213 to $35,563 USD per QALY gained. Over 1,000 iterations, there were 73.6%, 99.4%, and 91.8% probabilities that PP was cost-effective at a willingness to pay of $50,000 USD per QALY gained for breast cancer, NSCLC, and NHL, respectively. CONCLUSION: PP with a biosimilar filgrastim (specifically filgrastim-sndz) is cost-effective in patients with intermediate risk for FN receiving curative chemotherapy regimens for breast cancer, NSCLC, and NHL. Expanding the use of colony-stimulating factors for patients may be valuable in reducing unnecessary health care visits for patients with cancer at risk of complications because of COVID-19 and should be considered for the indefinite future. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|