OBJECTIVES: The study aims to analyze the pharmacoeconomic feasibility of using colony-stimulating factors (G-CSF) in supportive therapy, and to assess the economic consequences of following the guidelines for febrile neutropenia (FN) prevention.

METHODS: The target population included patients at high risk of FN in association with cancer chemotherapy (CT). We conducted cost of illness (COI), cost-effectiveness (CEA) and budget impact analyses (BIA). COI involved modeling costs of chemotherapy, prevention and management of FN. We analyzed COI dynamics associated with G-CSF prophylaxis of patients at high risk of chemotherapy-induced FN. CEA determined the cost-effectiveness of chemotherapy, including the FN prevention, and, as a consequence, maintenance of the recommended chemotherapy protocol. The model time horizon was 12 months.

RESULTS: Chemotherapy without FN prophylaxis is associated with the highest costs of € 13,903. Adoption of G-CSF for FN prevention leads to the total costs reduction of €2,057 - €4,726 per patient depending on the drug used. Empegfilgrastim prophylaxis results in the lowest total costs (34% lower than in the absence of FN prevention). An estimated target population size was 242,915. The absence of FN prevention in this population imposes the socioeconomic burden ranging from €499.5 million to € 1,147.8 million. In contrast, the use of recommended G-CSF drugs significantly increases the effectiveness of chemotherapy and thus cancer patients’ survival. Corresponding CERs were € 10,312.1 (for Empegfilgrastim), € 10,506.7 (Lipegfilgrastim), € 11,025.4 (Filgrastim), € 11,556.8 (Pegfilgrastim), € 13,310.5 (Lenograstim), and € 17,378.6 (CT without FN prophylaxis with G-CSF).

CONCLUSIONS: The use of G-CSF as a preventive measure for the development of chemotherapy complications is economically viable from CEA and COI perspectives. Although the expansion of FN prophylaxis in cancer patients increases drug costs for the FN prevention, it also reduces the total costs of cancer patient treatment.