Pegfilgrastim for the prevention of febrile neutropenia in patients with epithelial ovarian carcinoma - A cost-effectiveness analysis

T. M. Numnum, Kristopher Kimball, R. P. Rocconi, Larry Kilgore, J. M. Straughn

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Abstract

The objective is to assess the cost-effectiveness of pegfilgrastim for the prevention of hospitalization due to febrile neutropenia (FN) in patients with epithelial ovarian carcinoma (EOC) receiving taxane/platinum-based chemotherapy. A decision analysis model evaluated a hypothetical cohort of 10,000 patients receiving six cycles of taxane/platinum-based chemotherapy for EOC. Three strategies were analyzed for the prevention of hospitalization due to FN: 1) dose modifications and delays after a hospitalization for FN without the use of granulocyte-colony stimulating factors (G-CSF) (NO G-CSF); 2) all patients receive G-CSF with each chemotherapy cycle (1° PROPHYLAXIS); 3) patients receive G-CSF for all subsequent chemotherapy cycles after a hospitalization for FN (2° PROPHYLAXIS). The model was applied to two patient populations: 1) an average-risk population (FN hospitalization rate = 5%); 2) a high-risk population (FN hospitalization rate = 16%). Using baseline assumptions in an average-risk population, NO G-CSF was the least expensive strategy with a cost of $68 million and resulted in 2,860 hospitalizations for FN. 2° PROPHYLAXIS resulted in 141 fewer hospitalizations than NO G-CSF at a cost of $76,288 per hospitalization prevented. 1° PROPHYLAXIS was the most effective and resulted in 1,689 fewer hospitalizations for FN compared to NO G-CSF at a cost of $47,343 per hospitalization prevented. When this model is applied to a high-risk patient population, 1° PROPHYLAXIS is more effective and less expensive than both NO G-CSF and 2° PROPHYLAXIS. We conclude that in average-risk patients receiving chemotherapy for EOC the use of pegfilgrastim is effective at reducing hospitalizations due to FN, but at a significant cost. However, in high-risk patients, primary prophylaxis is the only cost-effective strategy and should be strongly considered.

Original languageEnglish (US)
Pages (from-to)1019-1024
Number of pages6
JournalInternational Journal of Gynecological Cancer
Volume17
Issue number5
DOIs
StatePublished - Sep 1 2007

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Febrile Neutropenia
Cost-Benefit Analysis
Hospitalization
Granulocyte Colony-Stimulating Factor
Carcinoma
Costs and Cost Analysis
Drug Therapy
Population
Platinum
pegfilgrastim
Decision Support Techniques
Granulocyte-Macrophage Colony-Stimulating Factor

All Science Journal Classification (ASJC) codes

  • Oncology
  • Obstetrics and Gynecology

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Pegfilgrastim for the prevention of febrile neutropenia in patients with epithelial ovarian carcinoma - A cost-effectiveness analysis. / Numnum, T. M.; Kimball, Kristopher; Rocconi, R. P.; Kilgore, Larry; Straughn, J. M.

In: International Journal of Gynecological Cancer, Vol. 17, No. 5, 01.09.2007, p. 1019-1024.

Research output: Contribution to journalArticle

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