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Using Neupogen, Granix, or Zarxio Reduced Chemotherapy Costs Compared to Neulasta

January 2018

According to a poster presentation at the ASH 2017 Annual Meeting & Exposition, Neupogen, Granix, and Zarxio were substantially less expensive for preventing neutropenia than Neulesta for an average chemotherapy treatment cycle among patients being treated for nonmyeloid malignancies.

“Neutropenia is a common complication in patients receiving myelosuppressive chemotherapy for nonmyeloid malignancies,” Elizabeth James, PharmD, PhD, clinical writer at Aventine Consulting, and colleagues explained. “Severe and febrile neutropenia are associated with prolonged hospitalization, serious infections and broad-spectrum antibiotic use, decreased quality of life, increased medical costs, and mortality.”

In order to prevent febrile neutropenia, granulocyte colony-stimulating factors (G-CSF) are administered during chemotherapy. 

“While pegfilgrastim is dosed once per chemotherapy cycle (14-day efficacy), data suggest the average duration of short-acting G-CSF use is considerably shorter than 14 days,” the researchers wrote. “[Our] analysis estimated the budget impact of increasing utilization of short-acting G-CSFs while decreasing utilization of long-acting [Neulasta (pegfilgrastim; Amgen)] products for patients with nonmyeloid malignancies treated with myelosuppressive chemotherapy from a US payer perspective.”

The three short-acting drugs used in the comparative study were Neupogen (filgrastim; Amgen), Granix (tbo-filgrastim; Teva), and Zarxio (filgrastim-sndz; Sandoz).

The per-member per-year cost of an annual health plan was $419.99 after the switch for the short-acting drugs compared with $425.53 while using Neulasta. Furthermore, per-patient savings for Granix and Zarxio ranged from 16.1% to 54.5%—based on dose and adjudication channel.

“Budget impact analyses... help decision makers determine how best to allocate resources,” Dr James and colleagues concluded. “Without considering additional impacts of health plan contracted rates and manufacturer rebates, the annual plan per-patient drug cost for [Granix] and [Zarxio] formulations were substantially less expensive than [Neulasta] for an average treatment cycle.”

David Costill