Reducing GCSF Increases Incidence of Neutropenia

Hematopoietic growth factors

Hematopoietic growth factors (Photo credit: Wikipedia)

A study involving 167 patients was published in the December 1 issue of the Journal of Clinical Oncology and reported that when the use of prophylactic granulocyte-colony stimulating factor (G-CSF) to reduce febrile neutropenia (FN) was decreased in patients receiving chemotherapy for breast cancer, it led to a more than 5-fold increase in FN episodes and an early end to the clinical trial.

In an accompanying study, Dr. Aarts’s research team evaluated the cost effectiveness of pegfilgrastim prophylaxis for FN. They conclude that skipping G-CSF after the first 2 chemo cycles saved an average of €3491 per patient. They estimate that nationwide, this would translate into a saving of €14.3 million each year.

However, this resulted in an unexpected and substantial increase in FN incidence. The researchers calculate that the incremental cost-effectiveness ratio for preventing an FN episode by giving G-CSF with every chemotherapy cycle, compared with only for the first 2 cycles, worked out to €13,112 per patient.

“When one is willing to pay at least €13,122 per patient with FN episodes prevented, 6 cycles of G-CSF prophylaxis is considered a cost-effective strategy,” they conclude.

Read More: Medscape

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