Real-World Economic and Clinical Outcomes of Pegfilgrastim via Prefilled Syringe vs On-Body Injector

Findings from a real-world study report no statistically or clinically meaningful differences in febrile neutropenia (FN) incidence between on-body injector (OBI) and prefilled syringe methods of pegfilgrastim administration, and no differences in total health care resource utilization (HCRU) or total costs (J Manag Care Spec Pharm. 2021; 27[9]:1230-1238. doi:10.18553/jmcp.2021.21010).

Ali McBride, PharmD, MS, BCOP, Banner University Medical Center and University of Arizona Cancer Center, Tucson, AZ, and colleagues aimed to “compare real-world clinical and economic outcomes between PFS and OBI methods of administration.”

This study included 3152 patients diagnosed with either breast cancer or nonHodgkin lymphoma who received myelosuppressive chemotherapy and prophylactic use of pegfilgrastim via prefilled syringe or OBI between January 1, 2017, and May 31, 2018. Participants were identified through MarketScan research databases.

Those in the prefilled syringe cohort were matched 1:1 to those in the OBI cohort using a propensity score. A liner model and generalized estimating equations with log-link function compared outcomes among the matched cohorts.

Once matched, there were 1085 patients included in each cohort. In the first chemotherapy cycle, the incidence of FN was 0.1% for OBI, and 1.48% for prefilled syringe (P = .336). The FN incidence was 0.91% for OBI, and 1.22% for prefilled syringe, when observing all chemotherapy cycles (7467 total cycles; P = 0.214).

Between adjusted per-member per-month all-cause total cost HCRU for hospitalizations, emergency department visits, and pharmacy claims, no statistically significant difference was observed. 

“In a matched cohort of patients representing real-world utilization, there was no statistically or clinically meaningful difference in FN incidence between OBI and PFS methods of pegfilgrastim administration,” the authors wrote, adding, “There was no difference in total HCRU or total costs.”

“OBI and PFS methods of administration are both indicated for patients requiring prophylactic pegfilgrastim, which is important considering that biosimilar PFS options are now available,” concluded Dr McBride and colleagues.