Comparison of Efficacy and Cost-Effectiveness of Filgrastim, tbo-Filgrastim, and Filgrastim-sndz in Patients with Cancer Receiving Myelosuppressive Chemotherapy and Patients with Severe Chronic Neutropenia

Colony-stimulating factors (CSFs) have been used in the United States since 1991, since the approval of filgrastim, and regulate the production of neutrophils within the bone marrow. CSFs are indicated for use in cancer patients receiving myelosuppressive chemotherapy, patients with acute myeloid leukemia receiving induction or consolidation chemotherapy, cancer patients receiving bone marrow transplant, patients undergoing peripheral blood progenitor cell collection and therapy, and patients with severe chronic neutropenia. The objective of this study is to compare the efficacy, cost, and adverse effects of filgrastim, tbo-filgrastim, and filgrastim-sndz in a community hospital.

All 3 CSFs are currently being used at Indian River Medical Center (IRMC), and the data have been collected through the IRMC electronic medical record to compare the efficacy, cost, and adverse effects of the 3 products. The following data will be collected: age, sex, ethnicity, white blood cell (WBC) trends, absolute neutrophil count (ANC) trends, intravenous anti-infective use, incidence of bone pain, incidence of nausea, length of stay, and hospital costs. They also will review the 6 months of utilization data for each product: filgrastim, tbo-filgrastim, and filgrastim-sndz.

The investigators’ primary outcome will be the comparison of WBC count and ANC trends among the 3 products, and the difference in the length of stay and hospital costs among patients receiving each medication. The secondary end point that will be tested is the incidence of bone pain and nausea of each CSF product. The efficacy and cost-effectiveness of each product will be evaluated using the student t test and chi square analysis. The investigators anticipate the study will begin in early 2017.

Patel M. Abstract presented at ASHP Midyear Clinical Meeting. Las Vegas, NV; December 2016.

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