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.

Keywords:

• Bleomycin lung toxicity
• cost-effectiveness analysis
• decision analysis
• G-CSF
• Hodgkin lymphoma
• secondary prophylaxis

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article at http://dx.doi.org/10.3109/10428194.2015.1117609 (www.informahealthcare.com/lal). Dr Cheung receives funding from the Roy and Marjorie Linden Fund and the Joan Fischer and James Rowland Fund.