EVALUATING THE TOTAL MEDICAL COSTS OF G-CSF PROPHYLAXIS VERSUS NON-PROPHYLAXIS IN SACITUZUMAB GOVITECAN-TREATED BREAST CANCER PATIENTS IN ASIA
Author(s)
Yu-Chi Lin1, KAI-CHENG CHANG, MS2.
1Taoyuan City, Taiwan, 2National Cheng Kung University, Taoyuan City, Taiwan.
1Taoyuan City, Taiwan, 2National Cheng Kung University, Taoyuan City, Taiwan.
OBJECTIVES: Sacituzumab govitecan (SG) carries clinical benefits for breast cancer and intermediate risk for febrile neutropenia. Routine primary prophylaxis is not widely implemented in Taiwanese clinical practice due to restricted granulocyte colony-stimulating factor (G-CSF) coverage. This study compared the total medical costs between prophylaxis and non-prophylaxis in SG-treated breast cancer patients.
METHODS: We conducted a retrospective cohort study using multi-institutional electronic medical records in Taiwan. Metastatic breast cancer patients with a history of severe neutropenia (ANC less than 500/mm³) treated with SG between 2023 and 2026 were included. A landmark time of days 0-8 after SG initiation was applied to categorize patients into prophylaxis and non-prophylaxis groups. Patients who had severe neutropenia within the landmark time were excluded. For primary outcome, G-CSF expenses were calculated using Taiwan NHI prices. Neutropenia-related hospitalization costs were estimated via the Taiwan Diagnosis-Related Groups system. Costs were compared between groups and converted to euros (€) for descriptive analysis. Secondary outcome was median overall survival (OS) using Kaplan-Meier method.
RESULTS: In total, 58 patients (median age: 59.1 years) with a history of severe neutropenia were included. The secondary outcome of median OS was 8.1 months (95% CI: 5.3-13.9). Eleven patients received G-CSF prophylaxis and 47 did not. Severe neutropenia recurrence rate was 9.09% (1/11) in the prophylaxis group versus 12.77% (6/47) in the non-prophylaxis group. Severe neutropenia-related hospitalizations in non-prophylaxis (10.64% [5/47]) were insignificantly higher than in prophylaxis (0.00% [0/11]). The mean hospitalization cost per patient was €602.14 in the non-prophylaxis group, while the mean G-CSF drug cost was €145.93 in the prophylaxis group. For every €100 spent on G-CSF prophylaxis, approximately €412 in hospitalization costs may be saved.
CONCLUSIONS: G-CSF prophylaxis reduced neutropenia-related hospitalizations and lowered medical costs in high-risk patients. However, due to the small sample size, larger studies and more robust economic models are needed.
METHODS: We conducted a retrospective cohort study using multi-institutional electronic medical records in Taiwan. Metastatic breast cancer patients with a history of severe neutropenia (ANC less than 500/mm³) treated with SG between 2023 and 2026 were included. A landmark time of days 0-8 after SG initiation was applied to categorize patients into prophylaxis and non-prophylaxis groups. Patients who had severe neutropenia within the landmark time were excluded. For primary outcome, G-CSF expenses were calculated using Taiwan NHI prices. Neutropenia-related hospitalization costs were estimated via the Taiwan Diagnosis-Related Groups system. Costs were compared between groups and converted to euros (€) for descriptive analysis. Secondary outcome was median overall survival (OS) using Kaplan-Meier method.
RESULTS: In total, 58 patients (median age: 59.1 years) with a history of severe neutropenia were included. The secondary outcome of median OS was 8.1 months (95% CI: 5.3-13.9). Eleven patients received G-CSF prophylaxis and 47 did not. Severe neutropenia recurrence rate was 9.09% (1/11) in the prophylaxis group versus 12.77% (6/47) in the non-prophylaxis group. Severe neutropenia-related hospitalizations in non-prophylaxis (10.64% [5/47]) were insignificantly higher than in prophylaxis (0.00% [0/11]). The mean hospitalization cost per patient was €602.14 in the non-prophylaxis group, while the mean G-CSF drug cost was €145.93 in the prophylaxis group. For every €100 spent on G-CSF prophylaxis, approximately €412 in hospitalization costs may be saved.
CONCLUSIONS: G-CSF prophylaxis reduced neutropenia-related hospitalizations and lowered medical costs in high-risk patients. However, due to the small sample size, larger studies and more robust economic models are needed.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
RWD135
Topic
Clinical Outcomes, Economic Evaluation, Real World Data & Information Systems
Topic Subcategory
Health & Insurance Records Systems
Disease
Oncology