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Comparison of the usage of granulocyte colony-stimulating factors (G-CSF) in the Baltic and Nordic countries in 2011-2014

Date

09 Oct 2016

Session

Poster display

Presenters

Elen Vettus

Citation

Annals of Oncology (2016) 27 (6): 497-521. 10.1093/annonc/mdw390

Authors

E. Vettus1, K. Kurvits2, K. Oselin1

Author affiliations

  • 1 Department Of Chemotherapy, North Estonia Medical Centre, 13419 - Tallinn/EE
  • 2 Department Of Post-authorisation Safety, State Agency of Medicines, Tartu/EE
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Background

We aimed to analyse the use of G-CSF in the Nordic and Baltic countries and to compare the use of short- (filgrastim and its analogs) and long-acting (pegfilgrastim) G-CSFs in three cancer centres in Estonia with similar patient profile and identical reimbursement system.

Methods

G-CSFs were classified according to the Anatomical Therapeutic Chemical (ATC) classification (2015), the number of defined daily doses (DDD) per 1000 inhabitants per day was used as a measurement (DDD is 350 mcg for filgrastim and 300 mcg for pegfilgrastim). National consumption data (based on wholesale data) of G-CSF in the Nordic and Baltic countries were obtained from the Estonian Agency of Medicines. Dispensed G-CSF in three cancer centres in Estonia was obtained from hospital pharmacies. Number of patients and chemotherapy courses delivered per year per hospital were retrieved from the Estonian Health Insurance Fund and were compared with the dispensed G-CSF in each hospital.

Results

The use of G-CSF in the Nordic and Baltic countries in 2011-2014 using DDD/1000 inhabitants/day

Year Finland Norway Sweden Denmark Lithuania Latvia Estonia EE-1* EE-2* EE-3*
2011 0.2 0.1 0.04 0.1 0.04 0.07 0.03 0.37 0.67 0.12
2012 0.19 0.11 0.03 0.1 0.06 0.08 0.04 0.43 0.77 0.10
2013 0.16 0.12 0.03 0.2 0.07 0.1 0.05 0.57 1.0 0.13
2014 0.16 0.14 0.03 0.2 0.08 0.1 0.06 0.64 1.0 0.20

*Dispensed G-CSF (0,3mg) per chemotherapy courses in three cancer centres in Estonia In 2014 the consumption of G-CSF in Sweden was 85% lower than in Denmark, Denmark and Finland using only pegfilgrastim. Latvia has used the most G-CSF when compared to other Baltics and in 2013 their use of long-acting G-CSF was 8 times higher than in Lithuania. Filgrastim was the most used G-CSF in Estonia, G-CSF consumption varied 5 fold between cancer centres.

Conclusions

According to the national medicines use data the overall consumption of G-CSFs is highly variable in the Nordic and Baltic countries despite clear and updated guidelines by ESMO and ASCO. Consumption of G-CSFs has steadily increased in the three Baltic countries, most likely due to the availability of filgrastim biosimilars. The observed remarkable differences between use of G-CSF in the Nordic countries are difficult to explain.

Clinical trial identification

Legal entity responsible for the study

North Estonia Medical Centre, Tallinn, Estonia

Funding

North Estonia Medical Centre, Tallinn, Estonia

Disclosure

All authors have declared no conflicts of interest.

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