@article {Dominguez-Gil204, author = {A. Dominguez-Gil and A. Alegre and A. Lopez and I. Oyag{\"u}ez and L. Gutierrez and G. Restovic and M.A. Casado}, title = {Cost-effectiveness analysis of febrile neutropenia (FN) prophylaxis with pegfilgrastim in non-Hodgkin{\textquoteright}s lymphoma (NHL) patients treated with chemotherapy in Spain}, volume = {19}, number = {2}, pages = {204--205}, year = {2012}, doi = {10.1136/ejhpharm-2012-000074.314}, publisher = {BMJ Specialist Journals}, abstract = {Background Granulocyte-colony stimulating factor (G-CSF) prophylaxis reduces the risk of FN in NHL patients receiving myelosuppressive chemotherapy. View this table:Table 1 Costs and QALYs gained by strategy Purpose To estimate incremental cost-effectiveness ratios (ICERs) of pegfilgrastim prophylaxis versus other prophylaxis strategies in NHL patients from the perspective of the Spanish NHS. Materials and methods A Markov model simulated lifetime effectiveness (quality adjusted life years-QALYs) and cost ({\texteuro}2011) in NHL patients receiving CHOP21{\textpm}R. Pegfilgrastim was compared with 11-day filgrastim (Neupogen), 6-day filgrastim, and no prophylaxis (no use of G-CSF); these strategies were compared within primary (PP) and secondary (SP) prophylaxis. Model inputs were: risk of FN, mortality, probability of relative dose intensity RDI\<85\%, relative FN-risk of strategies, and utilities. The annual discount rate for cost and outcomes was 3\%. Results Effectiveness analyses (QALYs) demonstrated pegfilgrastim-PP was the most effective treatment. Assuming an accepted threshold of {\texteuro}30,000/QALY, PP with pegfilgrastim versus other PP strategies was cost-effective for CHOP21 (ICER of pegfilgrastim vs 11-day filgrastim, 6-day filgrastim or no prophylaxis of {\texteuro}3,606, {\texteuro}8,383 and {\texteuro}14,881 per QALY, respectively) and CHOP21-R (ICER of pegfilgrastim vs 11-day filgrastim, 6-day filgrastim or no prophylaxis of {\texteuro}5,895, {\texteuro}11,433 and {\texteuro}18,898 per QALY, respectively). Similarly, SP with pegfilgrastim versus other SP strategies was cost-effective, being the dominant SP strategy (more effective and less costly) versus 11- and 6-day filgrastim for CHOP21 and 11-day filgrastim for CHOP21-R. Compared to no prophylaxis, pegfilgrastim-SP had an ICER of {\texteuro}4,806/QALY for CHOP21 and {\texteuro}7,235/QALY for CHOP21-R. Conclusions Pegfilgrastim prophylaxis is an effective and cost-effective treatment for NHL patients for the Spanish NHS.}, issn = {2047-9956}, URL = {https://ejhp.bmj.com/content/19/2/204.3}, eprint = {https://ejhp.bmj.com/content/19/2/204.3.full.pdf}, journal = {European Journal of Hospital Pharmacy} }