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Whyte, S., Cooper, K..L, Stevenson, M.D. et al. (2 more authors) (Completed: 2011) Cost-effectiveness of granulocyte colony-stimulating factor prophylaxis for febrile neutropenia in breast cancer in the United Kingdom. HEDS Discussion Paper , 11-01.
Abstract
Introduction: We report a cost-effectiveness evaluation of granulocyte colony–stimulating factors (G-CSFs) for the prevention of febrile neutropenia (FN) after chemotherapy in the United Kingdom (UK).
Methods: A mathematical model was constructed simulating the experience of women with breast cancer undergoing chemotherapy. Three strategies were modelled: primary prophylaxis (G-CSFs administered in all cycles), secondary prophylaxis (G-CSFs administered in all cycles after an FN event), and no G-CSF prophylaxis. Three G-CSFs were considered: filgrastim, lenograstim, and pegfilgrastim. Costs were taken from UK databases and utility values from published sources. A systematic review provided data on G-CSF efficacy. Probabilistic sensitivity analyses examined the effects of uncertainty in model parameters.
Results: In the UK, base-case analysis with a willingness-to-pay (WTP) threshold of £20,000 per quality-adjusted life-year gained and using list prices, the most cost-effective strategy was primary prophylaxis with pegfilgrastim for a patient with baseline FN risk greater than 38%, secondary prophylaxis with pegfilgrastim for baseline FN risk 11% to 37%, and no G-CSFs for baseline FN risk less than 11%. Using a WTP threshold of £30,000 and list prices, primary prophylaxis with pegfilgrastim was cost-effective for baseline FN risks greater than 29%. In all analyses, pegfilgrastim dominated filgrastim and lenograstim. Sensitivity analyses demonstrated that higher WTP threshold, younger age, earlier stage at diagnosis, or reduced G-CSF prices result in G-CSF prophylaxis being cost-effective at lower baseline FN risk levels.
Conclusion: Pegfilgrastim was the most cost-effective G-CSF. The most cost-effective strategy (primary or secondary prophylaxis) was dependent on the FN risk level for an individual patient, patient age and stage at diagnosis, and G-CSF price.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Keywords: | cost-effectiveness; economic model; febrile neutropenia; granulocyte colony–stimulating factors; prophylaxis |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield) > Health Economics and Decision Science > HEDS Discussion Paper Series |
Depositing User: | ScHARR / HEDS (Sheffield) |
Date Deposited: | 11 Jul 2012 09:17 |
Last Modified: | 05 Jun 2014 23:41 |
Status: | Published |
Series Name: | HEDS Discussion Paper |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:74368 |
Available Versions of this Item
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Cost-effectiveness of granulocyte colony-stimulating factor prophylaxis for febrile neutropenia in breast cancer in the United Kingdom. (deposited 05 Apr 2011 14:19)
- Cost-effectiveness of granulocyte colony-stimulating factor prophylaxis for febrile neutropenia in breast cancer in the United Kingdom. (deposited 11 Jul 2012 09:17) [Currently Displayed]