title: Cost comparison of outpatient treatment with granulocyte colony-stimulating factors (G-CSF) in Germany.
abstract: BACKGROUND
  Granulocyte colony-stimulating factors (G-CSF), are available for prevention of neutropenia and reduction of its complications in cytostatic chemotherapy. The purpose of this analysis was to determine the consumption rates for various G-CSF and to compare outpatient medication costs per patient and treatment cycle.
  
  
  METHODS
  Prescription data of statutory health insurance members in Germany (IMS®LRx database) with G-CSF prescriptions between January 2008 and July 2010 were evaluated. A period of observation of at least 6 months prior to and after the G-CSF prescription was required.
  
  
  RESULTS
  Prescription data of 8,726 patients treated with original filgrastim, 4,240 with biosimilar filgrastim, 6,456 with lenograstim, and 9,939 with pegfilgrastim were analyzed. The regression model showed statistically significant costreducing effects per cycle for treatment with lenograstim compared with non-lenograstim (-0.47 vs. original filgrastim; -0.15 vs. biosimilar filgrastim; -1.04 vs. pegfilgrastim; each p < 0.0001). This result has been adjusted for patient age, gender, number of injections, and prescribing specialist group.
  
  
  CONCLUSIONS
  Treatment with the original preparation lenograstim is significantly cheaper compared to the other two original drugs and biosimilar. The costs of G-CSF treatment with the original preparation lenograstim and the filgrastim biosimilars are in a similar range, but with a significantly lower cost for lenograstim. Compared to their reference product the biosimilars thus show a cost advantage.
authors.affiliation: Philipps-University of Marburg, Germany. Peyman.Hadji@t-online.de
authors.forename: Peyman
authors.initials: P
authors.lastname: Hadji
authors.forename: Karel
authors.initials: K
authors.lastname: Kostev
authors.forename: Detlef
authors.initials: D
authors.lastname: Schröder-Bernhardi
authors.forename: Volker
authors.initials: V
authors.lastname: Ziller
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000191:economics*; D059451:Biosimilar Pharmaceuticals / Q000191:economics* / Q000627:therapeutic use*; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D019992:Databases as Topic; D016527:Drug Costs; D011307:Drug Prescriptions / Q000191:economics; D005260:Female; D000069585:Filgrastim; D005858:Germany; D016179:Granulocyte Colony-Stimulating Factor / Q000191:economics* / Q000627:therapeutic use*; D006801:Humans; D007356:Insurance, Pharmaceutical Services / Q000191:economics; D000078224:Lenograstim; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D009503:Neutropenia / Q000188:drug therapy* / Q000191:economics*; D010043:Outcome and Process Assessment, Health Care / Q000191:economics*; D011092:Polyethylene Glycols; D011994:Recombinant Proteins / Q000191:economics / Q000627:therapeutic use; D012044:Regression Analysis; D013222:State Medicine / Q000191:economics; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D059451:Biosimilar Pharmaceuticals; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; C455861:pegfilgrastim; D011092:Polyethylene Glycols; D000078224:Lenograstim; D000069585:Filgrastim