title: Granulocyte colony-stimulating factor in secondary prophylaxis for advanced-stage Hodgkin lymphoma treated with ABVD chemotherapy: a cost-effectiveness analysis.
abstract: 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.
authors.affiliation: a Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto , Toronto , Canada ;
authors.forename: M C
authors.initials: MC
authors.lastname: Cheung
authors.affiliation: b Princess Margaret Hospital and Mt. Sinai Hospital, University of Toronto , Toronto , Canada ;
authors.forename: A
authors.initials: A
authors.lastname: Prica
authors.affiliation: c Grand River Regional Cancer Centre , Kitchener , Canada ;
authors.forename: J
authors.initials: J
authors.lastname: Graczyk
authors.affiliation: a Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto , Toronto , Canada ;
authors.forename: R
authors.initials: R
authors.lastname: Buckstein
authors.affiliation: a Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto , Toronto , Canada ;|d Division of Biostatistics , Dalla Lana School of Public Health, University of Toronto , Toronto , Canada.
authors.forename: K K W
authors.initials: KK
authors.lastname: Chan
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001761:Bleomycin / Q000627:therapeutic use; D002170:Canada; D064146:Chemotherapy-Induced Febrile Neutropenia / Q000517:prevention & control*; D015331:Cohort Studies; D003362:Cost-Benefit Analysis / Q000379:methods*; D003606:Dacarbazine / Q000627:therapeutic use; D020000:Decision Support Systems, Clinical; D004317:Doxorubicin / Q000627:therapeutic use; D016179:Granulocyte Colony-Stimulating Factor / Q000191:economics* / Q000627:therapeutic use; D006689:Hodgkin Disease / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008390:Markov Chains; D009367:Neoplasm Staging; D019057:Quality-Adjusted Life Years; D055502:Secondary Prevention / Q000191:economics* / Q000379:methods; D016896:Treatment Outcome; D014747:Vinblastine / Q000627:therapeutic use
chemical_list: D001761:Bleomycin; D016179:Granulocyte Colony-Stimulating Factor; D014747:Vinblastine; D003606:Dacarbazine; D004317:Doxorubicin
keywords: Bleomycin lung toxicity; G-CSF; Hodgkin lymphoma; cost-effectiveness analysis; decision analysis; secondary prophylaxis