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Economic evaluations of granulocyte colony-stimulating factor

In the prevention and treatment of chemotherapy-induced neutropenia

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Abstract

The prevailing uncertainty about the pharmacoeconomic positioning of granulocyte colony-stimulating factor (G-CSF) in the prevention and treatment of chemotherapy-induced febrile neutropenia has resulted in a number of pharmacoeconomic evaluations published in the past 10 years. These studies vary considerably regarding the approaches used and the results presented. In order to contribute to a clearer pharmacoeconomic positioning of G-CSF, a systematic review of economic evaluations was carried out.

The focus of the review was prophylaxis and therapy of chemotherapy-induced neutropenia in patients with cancer. A computerised bibliography search of several databases was conducted yielding 33 studies.

The findings demonstrated the cost-saving potential of G-CSF in standard-dose chemotherapy to be limited, with lower costs often seen in the control group. The results of these studies were too heterogeneous to extract a clear recommendation from a cost-saving point of view. The administration of G-CSF after high-dose chemotherapy with stem cell support resulted more often in cost savings in the G-CSF group as compared with standard-dose chemotherapy, illustrating a possible cost-saving potential of G-CSF. In the treatment of established chemotherapy-induced febrile neutropenia, cost savings were found in all studies. This result is surprising but hampered by the small number of studies (n = 5) and remains to be confirmed by more rigourously designed prospective economic analyses.

Despite the substantial research on this topic, the economic evaluation of G-CSF is far from being settled and needs further investigation.

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Acknowledgements

There was no funding provided for this work. The authors have provided no information on conflicts of interest directly relevant to the content of this review.

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  1. Institute of Health Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany

    Marc Esser & Helmut Brunner

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  1. Marc Esser
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Correspondence to Marc Esser.

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Esser, M., Brunner, H. Economic evaluations of granulocyte colony-stimulating factor. Pharmacoeconomic 21, 1295–1313 (2003). https://doi.org/10.1007/BF03262329

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