Granulocyte colony-stimulating factor in secondary prophylaxis for advanced-stage Hodgkin lymphoma treated with ABVD chemotherapy: a cost-effectiveness analysis.
Granulocyte colony-stimulating factor (G-CSF) is commonly administered to patients with Hodgkin lymphoma (HL) with neutropenia. We constructed a decision-analytic model to compare the cost-effectiveness of secondary prophylaxis with G-CSF to a strategy of 'no G-CSF' in response to severe neutropenia for adults with advanced-stage HL treated with ABVD. A Canadian public health payer's perspective was considered and costs were presented in 2013 Canadian dollars. The quality-adjusted life years (QALYs) attained with the G-CSF and 'no G-CSF' strategies were 1.403 and 1.416, respectively. Costs for the strategies with and without G-CSF were $38,971 and $33,982, respectively. In the base case analysis, the 'no G-CSF' strategy was associated with cost savings and improved QALYs; therefore, 'no G-CSF' was the dominant approach. For patients with severe neutropenia during ABVD chemotherapy for advanced-stage HL, a strategy without G-CSF support is associated with improved quality-adjusted outcomes, cost savings, and is the preferred approach.
['Cheung|M C|MC|', 'Prica|A|A|', 'Graczyk|J|J|', 'Buckstein|R|R|', 'Chan|K K W|KK|']
D000328:Adult D000971:Antineoplastic Combined Chemotherapy Protocols D001761:Bleomycin D002170:Canada D064146:Chemotherapy-Induced Febrile Neutropenia D015331:Cohort Studies D003362:Cost-Benefit Analysis D003606:Dacarbazine D020000:Decision Support Systems, Clinical D004317:Doxorubicin D016179:Granulocyte Colony-Stimulating Factor D006689:Hodgkin Disease D006801:Humans D008390:Markov Chains D009367:Neoplasm Staging D019057:Quality-Adjusted Life Years D055502:Secondary Prevention D016896:Treatment Outcome D014747:Vinblastine
secondary prophylaxis Hodgkin lymphoma cost-effectiveness analysis G-CSF Bleomycin lung toxicity decision analysis