Administration options for pegfilgrastim prophylaxis: patient and physician preferences from a cross-sectional survey
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Although clinical guidelines recommend administration of pegfilgrastim 1–4 days after a myelosuppressive chemotherapy cycle to decrease the incidence of febrile neutropenia (FN), some physicians administer pegfilgrastim on the same day as chemotherapy administration. A novel on-body injector (OBI) that automatically delivers pegfilgrastim the day after chemotherapy is also available. Our objective was to estimate patient and physician preferences among the pegfilgrastim administration options.
We conducted a cross-sectional survey of patients receiving pegfilgrastim and physicians prescribing pegfilgrastim. Respondents’ preferences for pegfilgrastim administration options were elicited using direct elicitation; the relative importance of features associated with the options was estimated in a point-allocation exercise. Physicians considered two hypothetical patient profiles when completing the exercises.
The samples included 200 patients and 200 physicians. Patients generally preferred the administration option with which they had experience. Among patients, 48.5% with previous in-clinic injections 24 hours after chemotherapy preferred this option; 56.8% with previous OBI administration preferred this option. For a clinically compromised patient, 37.5% of physicians preferred an in-clinic injection option; 49.5% preferred the OBI. For a less compromised patient, 55.5% preferred an in-clinic injection option; 28.0% preferred the OBI. Avoiding the need to return to the clinic was chosen most often as the most important treatment feature for patients and physicians.
Patients and physicians identified that returning clinic visits for pegfilgrastim administration may be burdensome. A potential solution to mitigate this burden is the OBI, which allows adherence to the labeled use of pegfilgrastim without return visits to the clinic.
KeywordsPegfilgrastim Febrile neutropenia Preference Patient Physician
The authors gratefully acknowledge Jacob Garcia, MD, formerly of Amgen, Inc., for his clinical input on the study and the manuscript. Kate Lothman of RTI Health Solutions provided medical writing services, which were funded by Amgen, Inc.
Compliance with ethical standards
Conflicts of interest
This work was supported by Amgen, Inc., Thousand Oaks, CA, United States. ABH, BM, MAP, DW, and JAK are employees of RTI Health Solutions, which received research funding from Amgen, Inc. MB and DC are employees and stockholders of Amgen, Inc.
Statement of human rights
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 3.Neulasta® (pegfilgrastim) prescribing information (2016) Available from: http://pi.amgen.com/~/media/amgen/repositorysites/pi-amgen-com/neulasta/neulasta_pi_hcp_english.ashx. Accessed 9 December 2016
- 4.National Comprehensive Cancer Network (NCCN) (2015) Guidelines on myeloid growth factors, version 1. 2015. http://www.nccn.org/professionals/physician_gls/pdf/myeloid_growth.pdf. Accessed 1 September 2015
- 8.Neulasta Onpro healthcare provider instructions for use (2016) http://pi.amgen.com/united_states/neulasta/neulasta_ifu_hcp_pt_english.pdf. Accessed 10 November 2016
- 10.Devine S, Babrowicz J, Hahn R et al (2015) Intra-operative communication regarding neuromuscular blockade: a survey of anaesthesiologists and surgeons. J Anesth Clin Res 6:524–530Google Scholar
- 14.Joshi RS, Egbuna OI, Cairns AS et al (2016) Performance of the pegfilgrastim on-body injector as studied with placebo buffer in healthy volunteers. Curr Med Res Opin 5:1–21Google Scholar