期刊
JOURNAL OF MEDICAL ECONOMICS
卷 20, 期 10, 页码 1083-1093出版社
TAYLOR & FRANCIS LTD
DOI: 10.1080/13696998.2017.1358173
关键词
Filgrastim; pegfilgrastim; biosimilars; GCSF; neutropenia; febrile neutropenia; cost-efficiency
资金
- Sandoz, Inc.
Aims: Guidelines recommend prophylaxis with granulocyte colony-stimulating factor for chemotherapy-induced (febrile) neutropenia (CIN/FN) based on regimen myelotoxicity and patient-related risk factors. The aim was to conduct a cost-efficiency analysis for the US of the direct acquisition and administration costs of the recently approved biosimilar filgrastim-sndz (Zarxio EP2006) with reference to filgrastim (Neupogen), pegfilgrastim (Neulasta), and a pegfilgrastim injection device (Neulasta Onpro; hereafter pegfilgrastim-injector) for CIN/FN prophylaxis. Methods: A cost-efficiency analysis of the prophylaxis of one patient during one chemotherapy cycle under 1-14 days' time horizon was conducted using the unit dose average selling price (ASP) and Current Procedural Terminology (CPT) codes for subcutaneous prophylactic injection under four scenarios: cost of medication only (COSTMED), patient self-administration (SELFADMIN), healthcare provider (HCP) initiating administration followed by self-administration (HCPSTART), and HCP providing full administration (HCPALL). Two case studies were created to illustrate real-world clinical implications. The analyses were replicated using wholesale acquisition cost (WAC). Results: Using ASP+CPT, cost savings achieved with filgrastim-sndz relative to reference filgrastim ranged from $65 (1day) to $916 (14 days) across all scenarios. Relative to pegfilgrastim, savings with filgrastim-sndz ranged from $834 (14 days) up to $3,666 (1day) under the COSTMED, SELFADMIN, and HPOSTART scenarios; and from $284 (14 days) up to $3,666 (1day) under the HPOALL scenario. Similar to the cost-savings compared to pegfilgrastim, filgrastim-sndz achieved savings relative to pegfilgrastim-injector: from $834 (14 days) to $3,666 (1day) under the COSTMED scenario, from $859 (14 days) to $3,692 (1day) under SELFADMIN, from $817 (14 days) to $3,649 (1day) under HPOSTART, and from $267 (14 days) to $3,649 (1day) under HPOALL. Cost savings of filgrastim-sndz using WAC+CPT were even greater under all scenarios. Conclusions: Prophylaxis with filgrastim-sndz, a biosimilar filgrastim, was associated consistently with significant cost-savings over prophylaxis with reference filgrastim, pegfilgrastim, and pegfilgrastim-injector, and this across various administration scenarios.
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