PT - JOURNAL ARTICLE AU - A. Dominguez-Gil AU - A. Alegre AU - A. Lopez AU - I. Oyagüez AU - L. Gutierrez AU - G. Restovic AU - M.A. Casado TI - Cost-effectiveness analysis of febrile neutropenia (FN) prophylaxis with pegfilgrastim in non-Hodgkin's lymphoma (NHL) patients treated with chemotherapy in Spain AID - 10.1136/ejhpharm-2012-000074.314 DP - 2012 Apr 01 TA - European Journal of Hospital Pharmacy: Science and Practice PG - 204--205 VI - 19 IP - 2 4099 - http://ejhp.bmj.com/content/19/2/204.3.short 4100 - http://ejhp.bmj.com/content/19/2/204.3.full SO - Eur J Hosp Pharm2012 Apr 01; 19 AB - 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 (€2011) in NHL patients receiving CHOP21±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 €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 €3,606, €8,383 and €14,881 per QALY, respectively) and CHOP21-R (ICER of pegfilgrastim vs 11-day filgrastim, 6-day filgrastim or no prophylaxis of €5,895, €11,433 and €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 €4,806/QALY for CHOP21 and €7,235/QALY for CHOP21-R. Conclusions Pegfilgrastim prophylaxis is an effective and cost-effective treatment for NHL patients for the Spanish NHS.