OBJECTIVES: To assess the cost-effectiveness in Germany of primary prophylaxis (PP) with pegfilgrastim versus 6‑ or 11‑day filgrastim (F6, F11) in the prevention of febrile neutropenia (FN) in non-Hodgkin lymphoma (NHL) patients receiving CHOP‑14 chemotherapy and in breast cancer (BC) patients receiving TAC chemotherapy. METHODS: A payer perspective Markov model of febrile neutropenia prophylaxis in chemotherapy patients was developed.  PP was defined as initiating prophylaxis with the first chemotherapy cycle.  Model cycle length matches chemotherapy cycle length (CHOP-14:14 days, TAC: 21 days); model time horizon is the duration of chemotherapy (6 cycles). Cycle 1 FN risk with no prophylaxis was estimated to be 21% for NHL CHOP-14 and 14% for BC TAC; all cycle relative risks of FN versus no prophylaxis for PP using Pegfilgrastim, F6, and F11 were 0.25, 0.87 and 0.61, respectively, based on published literature and meta-analyses.  Pegfilgrastim cost was estimated as €1686 per chemotherapy cycle; corresponding costs for F6 and F11 were €1347 and €2469 based on German national pricing.  Incremental cost-effectiveness ratios (ICERs) were calculated per FN events avoided.  Costs and outcomes were discounted (3%/year). Sensitivity analyses were performed. RESULTS: For NHL FN events per patient were 0.15, 0.76, and 0.47 for Pegfilgrastim, F6, and F11, respectively. ICER for Pegfilgrastim versus F6 was €1386 per FN avoided. For BC, corresponding FN events per patient were 0.09, 0.43, and 0.27. The ICER for Pegfilgrastim versus F6 was €6651 per FN avoided. Pegfilgrastim was dominant (less costly, more effective) compared with F11 in both populations. Results were most sensitive to baseline risk of FN, cost of prophylaxis and cost of FN events. CONCLUSIONS: Primary prophylaxis with pegfilgrastim costs < €1400 per additional FN avoided compared with 6-day filgrastim for NHL patients treated with CHOP-14, and < €7000 for BC patients treated with TAC. Pegfilgrastim dominated 11-day filgrastim.