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Please use this identifier to cite or link to this item: http://ntour.ntou.edu.tw:8080/ir/handle/987654321/44593

Title: Cost-effectiveness of gra nulocyte colony- stimulating factorprophylaxis in chemotherapy-induced febrile neutrop eniaamong breast cancer and Non-Hodgkin’s lymphoma patientsunder Taiwan’s national health insurance system
Authors: Tsun-Jen Wen
Yu-Wen Wen
Chun-Ru Chien
Shao-Chin Chiang
William Wei-Yuan Hsu
Li-Jiuan Shen
Fei-Yuan Hsiao
Contributors: 國立臺灣海洋大學:資訊工程學系
NTOU:Department of Computer Science and Engineering
Keywords: National Health Insurance Research Database (NHIRD)
breast cancer
chemotherapy-induced febrile neutropenia (CIFN)
cost-effectiveness
granulocyte colony-stimulating factor (G-CSF)
non-Hodgkin's lymphoma (NHL)
Date: 2016
Issue Date: 2017-11-23T02:55:27Z
Publisher: Journal of Evaluation in Clinical Practice
Abstract: Abstract:

Rationale, aim and objective
The beneficial effects of granulocyte colony-stimulating factor (G-CSF) prophylaxis on reducing the risk of chemotherapy-induced febrile neutropenia (CIFN) were well documented throughout the literature. However, existing data regarding its cost-effectiveness were conflicting. We estimated the cost-effectiveness of G-CSF prophylaxis in CIFN under Taiwan's National Health Insurance (NHI) system.

Methods
Data on clinical outcomes and direct medical costs were derived for 5179 newly diagnosed breast cancer and 629 non-Hodgkin's lymphoma (NHL) patients from the NHI claims database. Patients were further categorized into three subgroups as “primary-”, “secondary-” and “no -” prophylaxis based on their patterns of G-CSF use. Generalized estimating equations were applied to estimate the impact of G-CSF use on the incidence of CIFN. The incremental cost-effectiveness ratios of primary and secondary prophylactic G-CSF use were calculated and sensitivity analyses were performed.

Results
Primary prophylaxis of G-CSF decreased the incidence of CIFN by 27% and 83%, while secondary prophylaxis by 34% and 22% in breast cancer and NHL patients, respectively. Compared with those with no prophylaxis, the incremental cost per CIFN reduced in primary prophylaxis is $931 and $52 among patients with breast cancer and NHL, respectively. In contrast, secondary prophylaxis is dominated by no prophylaxis and primary prophylaxis in both cancer patients.

Conclusion
Primary but not secondary prophylactic use of G-CSF was cost-effective in CIFN in breast cancer and NHL patients under Taiwan's NHI system.
Relation: 23(2), pp.288-293
URI: http://ntour.ntou.edu.tw:8080/ir/handle/987654321/44593
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