Annual patient and caregiver burden of oncology clinic visits for granulocyte-colony stimulating factor therapy in the US

Stephens, J. Mark; Li, Xiaoyan; Reiner, Maureen; Tzivelekis, Spiros

doi:10.3111/13696998.2016.1140052

Cited by 8 publications

(5 citation statements)

References 44 publications

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“…Unfortunately, the reasons why prophylaxis was not administered to so many patients in this study are unknown. While it is possible that other steps were taken to reduce the risk of FN, such as chemotherapy dose reductions (which are unobservable in the study database), it is also possible that patients were reluctant to return to the clinic to receive a pegfilgrastim injection on the day after chemotherapy [48,49]. Regardless of the reasons or the steps other than prophylaxis that were taken to prevent FN, our results demonstrate that patients with a history of FN were substantially more likely to experience a subsequent FN episode during their chemotherapy course, consistent with previous studies [38,50].…”

Section: Discussionmentioning

confidence: 99%

Use and effectiveness of pegfilgrastim prophylaxis in US clinical practice:a retrospective observational study

et al. 2019

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Background: Febrile neutropenia (FN) is a serious complication of myelosuppressive chemotherapy. Clinical practice guidelines recommend routine prophylactic coverage with granulocyte colony-stimulating factor (G-CSF)-such as pegfilgrastim-for most patients receiving chemotherapy with an intermediate to high risk for FN. Patterns of pegfilgrastim prophylaxis during the chemotherapy course and associated FN risks in US clinical practice have not been well characterized. Methods: A retrospective cohort design and data from two commercial healthcare claims repositories (01/2010-03/ 2016) and Medicare Claims Research Identifiable Files (01/2007-09/2015) were employed. Study population included patients who had non-metastatic breast cancer or non-Hodgkin's lymphoma and received intermediate/high-risk regimens. Pegfilgrastim prophylaxis use and FN incidence were ascertained in each chemotherapy cycle, and all cycles were pooled for analyses. Adjusted odds ratios for FN were estimated for patients who did versus did not receive pegfilgrastim prophylaxis in that cycle. Results: Study population included 50,778 commercial patients who received 190,622 cycles of chemotherapy and 71, 037 Medicare patients who received 271,944 cycles. In cycle 1, 33% of commercial patients and 28% of Medicare patients did not receive pegfilgrastim prophylaxis, and adjusted odds of FN were 2.6 (95% CI 2.3-2.8) and 1.6 (1.5-1.7), respectively, versus those who received pegfilgrastim prophylaxis. In cycle 2, 28% (commercial) and 26% (Medicare) did not receive pegfilgrastim prophylaxis; corresponding adjusted FN odds were comparably elevated (1.9 [1.6-2.2] and 1.6 [1.5-1.8]). Results in subsequent cycles were similar. Across all cycles, 15% of commercial patients and 23% of Medicare patients did not receive pegfilgrastim prophylaxis despite having FN in a prior cycle, and prior FN increased odds of subsequent FN by 2.1-2.4 times. Conclusions: Notwithstanding clinical practice guidelines, a large minority of patients did not receive G-CSF prophylaxis, and FN incidence was substantially higher among this subset of the population. Appropriate use of pegfilgrastim prophylaxis may reduce patient exposure to this potentially fatal but largely preventable complication of myelosuppressive chemotherapy.

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Section: Discussionmentioning

confidence: 99%

Use and effectiveness of pegfilgrastim prophylaxis in US clinical practice:a retrospective observational study

et al. 2019

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“…Nevertheless, our results elucidate that the viability of recurring visits for each patient is a priority for Colombian HCPs when choosing how to administrate pegfilgrastim without undermining therapeutic efforts. Previous research projects have set the precedent for the detrimental effects of time and economic burden on the likelihood of attendance to follow-up visits for GCSF prophylaxis and optimal care, in general [ 11 , 14 ].…”

Section: Discussionmentioning

confidence: 99%

Health professionals’ preferences with the use of pegfilgrastim on-body injector at oncology centers in 8 cities in Colombia

Larrarte-González,

Pineda-Posada,

Gaitán

et al. 2023

BMC Health Serv Res

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Background Febrile neutropenia associated with some chemotherapy regimens can lead to potentially fatal complications and high health care costs. Administration of pegfilgrastim using an On-Body Injector (OBI) may be more convenient for cancer patients and physicians in countries with limited access to high-complexity healthcare. This study aims to describe physician and nurse preferences regarding different options for administration of pegfilgrastim at cancer centers, the chemotherapy schemes for which pegfilgrastim is most frequently prescribed and how healthcare providers prioritize certain administration schemes according to patients’ access to healthcare services. Methods Observational, descriptive, cross-sectional study and survey, conducted between 2019 and 2020, to describe physician and nurse preferences regarding options for administration of pegfilgrastim at cancer centers, the demographics of the study population and characteristics of participating cancer centers. It included 60 healthcare professionals practicing at oncology centers from 8 cities in Colombia who were contacted and surveyed via telephone. Quantitative continuous variables were summarized using central tendency and dispersion measures. Results It was found that 35% of participants are haemato-oncologists, oncologists or hematologists, 30% are general practitioners, and 35% are other healthcare professionals (i.e., nurse, oncology nurse and head nurse). Our study shows that 48% of physicians prefer the use of OBI, particularly in the scheme of 24 h after myelosuppressive chemotherapy administrations. Regardless of patient frailty and travel time to the clinic, over 90% of healthcare providers (HCPs) prefer to prioritize preventing the patient from having to return to the clinic for pegfilgrastim administration as well as to increase healthcare staff availability through the use of OBI. Conclusions The present study is the first one in Colombia that sought the reasons behind HCPs’ choice to use OBI pegfilgrastim. Our results indicate that most professionals prefer to avoid the patient having to re-enter the care center for pegfilgrastim administration to facilitate access to healthcare for patients; patient characteristics and ease of transport are determining factors for respondents when choosing an option for drug administration. We found OBI is the preferred alternative by most HCPs and a good resource optimization strategy in the context of cancer patients’ health care in Colombia.

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“…23 In the United States, most G-CSF doses are administered during separate clinic visits, at least 24 h after administration of myelosuppressive chemotherapy, meaning that patients usually need to return to the clinic, often accompanied by a caregiver. 24 Although self-administration at home is an option, it can be undesirable due to high pharmacy co-pays, patient discomfort with self-treatment, and physician concerns. 24 Therefore, overall, the reduced use of G-CSFs with trilaciclib, together with the fact that trilaciclib is administered on the same day, prior to chemotherapy, has the potential to reduce the burden on health care systems, patients, and caregivers.…”

Section: Discussionmentioning

confidence: 99%

“…24 Although self-administration at home is an option, it can be undesirable due to high pharmacy co-pays, patient discomfort with self-treatment, and physician concerns. 24 Therefore, overall, the reduced use of G-CSFs with trilaciclib, together with the fact that trilaciclib is administered on the same day, prior to chemotherapy, has the potential to reduce the burden on health care systems, patients, and caregivers.…”

Section: Discussionmentioning

confidence: 99%

Trilaciclib prior to chemotherapy reduces the usage of supportive care interventions for chemotherapy‐induced myelosuppression in patients with small cell lung cancer: Pooled analysis of three randomized phase 2 trials

Ferrarotto

Anderson

Medgyasszay³

et al. 2021

Cancer Medicine

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Annual patient and caregiver burden of oncology clinic visits for granulocyte-colony stimulating factor therapy in the US

Abstract: The burden of clinic visits for G-CSF therapy is a significant addition to the total economic burden borne by cancer patients and their families.

Cited by 8 publications

References 44 publications

Use and effectiveness of pegfilgrastim prophylaxis in US clinical practice:a retrospective observational study

Use and effectiveness of pegfilgrastim prophylaxis in US clinical practice:a retrospective observational study

Health professionals’ preferences with the use of pegfilgrastim on-body injector at oncology centers in 8 cities in Colombia

Trilaciclib prior to chemotherapy reduces the usage of supportive care interventions for chemotherapy‐induced myelosuppression in patients with small cell lung cancer: Pooled analysis of three randomized phase 2 trials

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