Tbo-filgrastim more cost-effective than filgrastim for stem cell mobilization, engraftment

Compared with filgrastim, tbo-filgrastim delivers similar efficacy and confers a cost-savings benefit for autologous peripheral blood progenitor cell (PBPC) mobilization and stem cell engraftment, results of a retrospective review have shown.

No statistically significant differences were seen on CD34+ counts during stem cell mobilization, neutrophil engraftment, infection rates during the engraftment phase, nor duration of hospitalization during the engraftment phase.

More patients in the tbo-filgrastim group were administered plerixafor per protocol, which led to more patients meeting their PBPC collection goal in 1 day with fewer collection days overall. However, institutional protocol changes could have confounded this finding.

Use of tbo-filgrastim also resulted in an average cost savings of $2,664.26 per patient ($1,907.33 for PBPC mobilization and $756.93 for stem cell engraftment) when comparing dollars spent on granulocyte colony-stimulating factor products only.

This study included 71 patients who received an autologous haematopoietic stem cell transplant (HSCT) from 1 January 2013 to 31 December 2016 with a documented administration of tbo-filgrastim or filgrastim. The authors retrospectively compared tbo-filgrastim with filgrastim in the autologous HSCT setting approximately 1 year after a system-wide formulary change to the former for all on- and off-label indications.

“Filgrastim, a granulocyte colony-stimulating factor, is commonly used in autologous HSCTs to assist with PBPC collection and to support stem cell engraftment,” the authors said. “In the United States, tbo-filgrastim is approved under its own Biologic License Application and is limited to a single indication excluding the HSCT population.”