New data demonstrate that filgrastim-sndz (Zarxio®; Sandoz) is, in addition to being safe and effective, cost-effective as primary prophylaxis to decrease the incidence of chemotherapy-induced febrile neutropenia in early-stage breast cancer patients receiving curative chemotherapy who are at intermediate risk for febrile neutropenia.
The study, released by the American Society of Clinical Oncology Quality Care Symposium, to be held October 9 and 10, 2020, demonstrates that using filgrastim-sndz after the first cycle of docetaxel chemotherapy rather than waiting until the patient develops febrile neutropenia, is cost-effective based on a willingness to pay (WTP) threshold of U.S $ 50,000 per quality-adjusted life-year (QALY), a generic measure of disease burden, including both the quality and the quantity of life lived. Historically, due to the high cost of reference medicines, patients at intermediate risk are monitored for the development of febrile neutropenia before receiving a granulocyte colony-stimulating factor (G-CSF).
“These data add to the growing body of evidence on the cost-effectiveness of filgrastim-sndz as primary prophylaxis in cancer patients, including similar findings in patients with non-Hodgkin’s lymphoma and lung cancer, and support the recent NCCN recommendations during the COVID-19 pandemic,” said study author Edward Li, Pharm.D., Director, Health Economics and Outcomes Research at Sandoz.
“We’re committed to supporting strategies to improve patient care and enhance sustainability for overburdened health systems, including the greater adoption of biosimilars,” Li added.
These findings align with the recent National Comprehensive Cancer Network (NCCN) recommendations for febrile neutropenia prevention, which have been expanded in response to the potential higher risk of COVID-19 infection among cancer patients due to compromised immune systems. 
The NCCN now recommends administration of G-CSF as primary prophylaxis treatment for febrile neutropenia for both intermediate and high-risk patients after their first cycle of chemotherapy, with the goal of reducing emergency room and hospital visits. Before the pandemic, the guidelines only recommended routine primary prophylaxis for high-risk and selected intermediate-risk patients.
Highlights of prescribing information
Filgrastim-sndz (Zarxio®; Sandoz) [Prescribing Information]. Accessed September 22, 2020.
NDC 61314-318-01, NDC 61314-318-05, NDC 61314-318-10, NDC 61314-326-01, view less NDC 61314-326-05, NDC 61314-326-10
 National Comprehensive Cancer Network. Coronavirus Disease 2019 (COVID-19) Resources for the Cancer Care Community. Hematopoietic Growth Factors. Available at: https://www.nccn.org/covid-19/pdf/HGF_COVID-19.pdf. Accessed September 21, 2020.
 Li EC ,Mezzio D, Spargo A, Campbell KL, Lyman GH. Cost-effectiveness of filgrastim-sndz as primary prophylaxis (PP) versus secondary prophylaxis (SP) to prevent chemotherapy-induced febrile neutropenia (FN) in non-small cell lung cancer (NSCLC) patients at intermediate risk. Journal of Clinical Oncology 2020 38: 15_suppl, e19401-e19401
Featured image: Laboratory/Research and Development. Photo courtesy: © 2020 Sandoz. Used with permission.