Cost-effectiveness analysis of mecapegfilgrastim and recombinant human granulocyte stimulating factor for primary prophylaxis of chemotherapy-induced neutropenia in non-small cell lung cancer

Objective: To evaluate the ficacy, safety, and economics of mecapegfilgrastim and recombinant human granulocyte colony-stimulating factor (rhG-CSF) the primary prevention of chemotherapy-related neutropenia in non-small cell cancer (NSCLC). Materials and methods: Data from 181 patients with NSCLC who received intermediate risk chemotherapy were collected from the information system of a tertiary hospital in China. Patients were categorized into two groups: those treated with mecapegfilgrastim (n = 91) and those treated with rhG-CSF (n = 90). The clinical efficacy rates of neutropenia prevention were used as effect indicators, and a cost-effectiveness analysis was conducted from the perspective of the Chinese healthcare system. Logistic regression, generalized linear regression, and bootstrap methods were used for sensitivity analyses. Results: There was no statistical difference between the mecapegfilgrastim and rhG-CSF groups in clinical efficacy rates (98.9 vs. 97.8%). However, the total cost in the mecapegfilgrastim group was significantly higher than that in the rhG-CSF group (16,341.6 CNY 14,371.1 CNY, p = 0.03). The cost-minimiza tion analysis shows that mecapegfilgrastim is not cost-effective. The sensitivity analyses confirm that these results are robust. Conclusion: Compared with rhG-CSF, mecapeg- filgrastim is not a cost-effective strategy for NSCLC patients in neutropenia prevention in China.