Economic and clinical outcomes of pegfilgrastim via prefilled syringe vs on-body injector: A real-world data analysis

• Main Authors: Campbell, D. (Author), Campbell, K. (Author), Li, E. (Author), McBride, A. (Author), Schroader, B. (Author), Wang, W. (Author)
• Format: Article
• Language: English
• Published: Academy of Managed Care Pharmacy (AMCP) 2021
• Subjects: adult; Adult; aged; Aged; Aged, 80 and over; antineoplastic agent; Article; breast cancer; cancer chemotherapy; clinical outcome; clinical pharmacy; cohort analysis; controlled study; cyclophosphamide; data analysis; Data Analysis; devices; doxorubicin; drug cost; economic evaluation; economics; emergency ward; febrile neutropenia; female; Female; filgrastim; Filgrastim; health care cost; health care utilization; hospitalization; hospitalization cost; human; Humans; injection; Injections; macrogol; major clinical study; male; Male; middle aged; Middle Aged; multiple cycle treatment; nonhodgkin lymphoma; observational study; Outcome Assessment, Health Care; pegfilgrastim; Polyethylene Glycols; prophylaxis; Retrospective Studies; retrospective study; risk factor; rituximab; syringe; Syringes; very elderly; vincristine; young adult; Young Adult
• Online Access: View Fulltext in Publisher
• ISBN: 23760540 (ISSN)
• DOI: 10.18553/jmcp.2021.21010

BACKGROUND: Pegfilgrastim is available as a prefilled syringe (PFS) and an on-body injector (OBI). Whether the administration method of pegfilgrastim affects the effectiveness and health care resources has not been evaluated in the setting of routine care. OBJECTIVE: To compare real-world clinical and economic outcomes between PFS and OBI methods of administration. METHODS: This was a retrospective observational study in patients diagnosed with breast cancer or non-Hodgkin lymphoma who received myelosuppressive chemotherapy and prophylactic use of pegfilgrastim via PFS or OBI between January 1, 2017, and May 31, 2018, according to MarketScan research databases. A propensity score was used to match the PFS cohort 1:1 to the OBI cohort. Outcomes were compared among the matched cohorts using a generalized linear model and generalized estimating equations with log-link function. RESULTS: 3,152 patients were identified. After matching, the final sample included 2,170 patients, representing 1,085 in each cohort. The incidence of febrile neutropenia (FN) in the first chemotherapy cycle was 1.01% for OBI (95% CI = 0.56-1.82) vs 1.48% for PFS (95% CI = 0.91-2.39; P = 0.336). In all chemotherapy cycles (total cycles = 7,467), the FN incidence was 0.91% for OBI (95% CI = 0.64-1.30) vs 1.22% for PFS (95% CI = 0.90-1.64; P = 0.214). There was no statistically significant difference in adjusted per-member per-month all-cause total cost health care resource utilization (HCRU) for hospitalizations, emergency department visits, and pharmacy claims. CONCLUSIONS: In a matched cohort of patients representing real-world utilization, there was no statistically or clinically meaningful difference in FN incidence between OBI and PFS methods of pegfilgrastim administration. There was no difference in total HCRU or total costs. OBI and PFS methods of administration are both indicated for patients requiring prophylactic pegfilgrastim, which is important considering that biosimilar PFS options are now available. © 2021, Academy of Managed Care Pharmacy.