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Lenograstim and filgrastim in the febrile neutropenia prophylaxis of hospitalized patients: efficacy and cost of the prophylaxis in a retrospective survey

Authors Innocenti R, Rigacci L, Restelli U, Scappini B, Gianfaldoni G, Fanci R, Mannelli F, Scolari F, Croce D, Bonizzoni E, Perrone T, Bosi A

Received 7 September 2018

Accepted for publication 15 November 2018

Published 27 December 2018 Volume 2019:10 Pages 21—27


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Martin Bluth

Rolando Innocenti,1 Luigi Rigacci,1,2 Umberto Restelli,3,4 Barbara Scappini,1 Giacomo Gianfaldoni,1 Rosa Fanci,1 Francesco Mannelli,1 Francesca Scolari,3 Davide Croce,3,4 Erminio Bonizzoni,5 Tania Perrone,6 Alberto Bosi1

1Hematology Department, University of Florence and AOU Careggi, Florence, Italy; 2Hematology Unit and Bone Marrow Transplant Unit, San Camillo Forlanini Hospital, Rome, Italy; 3Center for Health Economics, Social and Health Care Management, LIUC – Università Cattaneo, Castellanza (VA), Italy; 4School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; 5Section of Medical Statistics and Biometry “GA Maccacaro”, Department of Clinical Science and Community, University of Milan, Milan, Italy; 6Medical Affairs Department, Italfarmaco SpA, Milan, Italy

We conducted a retrospective study to evaluate the efficacy and related costs of using two different molecules of granulocyte-colony stimulating factor (G-CSF) (lenograstim – LENO or filgrastim – FIL) as primary prophylaxis of chemotherapy-induced neutropenia in a hematological inpatient setting.
Methods: The primary endpoints of the analysis were the efficacy of the two G-CSFs in terms of the level of white blood cells, hemoglobin and platelets at the end of the treatment and the per capita direct medical costs related to G-CSF prophylaxis.
Results: Two hundred twelve patients (96 LENO, 116 FIL) have been evaluated. The following statistically significant differences have been observed between FIL and LENO: the use of a higher number of vials (11 vs 7; P<0.03) to fully recover bone marrow, a higher grade 3–4 neutropenia at the time of G-CSF discontinuation (29.3% vs 16.7%; P=0.031) and an increased number of days of hospitalization (8 vs 5; P<0.005). A longer hospital stay before discharge was necessary (12 vs 10), which reflects the higher final costs per patient (median treatment cost per cycle 10.706 € for LENO, compared to 12.623 € for FIL).
Conclusion: The use of LENO has been associated with a lower number of days of hospitalization, number of vials and less incidence of grade 3–4 neutropenia at the time of G-CSF discontinuation. LENO seems to be cost-saving when compared with FIL (–15.2%).

Keywords: lenograstim, filgrastim, biosimilar, cost, neutropenia
Corrigendum for this paper has been published.

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