Clinical and economic aspects of prescribing granulocyte colony-stimulating factor

Objective. To evaluate economic significance of febrile neutropenia (FN) prophylaxis using granulocyte colony-stimulating factors (G-CSF) in oncology patients receiving antineoplastic drug therapy (ADT) within compulsory health insurance (CHI) system. Material and methods. We compared the total costs of CHI system when using two alternative G-CSF drugs (filgrastim 300 µg for 4 days and empegfilgrastim 7.5 mg once), direct costs of CHI system aimed at reimbursing hospitals for purchase of G-CSF and subsequent savings of CHI funds that could be spent on care for immediate and mid-term (up to 12 months) outcomes of prevented FN. Results. The estimated costs for prevention of FN determined by reimbursing purchase of a medicinal product and cost of care for FN and its consequences at the intermediate and final points of the study amounted to 43.81 billion rubles for filgrastim and 41.89 billion rubles for empegfilgrastim. The difference in such costs for empegfilgrastim (with complete abandonment of filgrastim) demonstrated savings for CHI budget in amount of 1.92 billion rubles/year or 16 071 rubles/year per a patient. Conclusion. Despite higher costs of empegfilgrastim, subsequent reduction of costs following more effective prevention of adverse outcomes will ensure a positive financial result for CHI system over a 12-month period.