Abstract 1885P
Background
G-CSF are recommended to prevent febrile neutropenia (FN) in high risk (FN> 20%) chemotherapy treatments. When the FN risk is 10-20%, assessment of patient and disease characteristics is necessary. Exploring physicians’ preferences on their use of G-CSF would help to understand what determines their choices.
Methods
We use a Discrete Choice Experiment (DCE) method, in a national sample of oncologists to elicit their preferences in term of G-CSF use. The most relevant attributes and their levels were determined with a multidisciplinary expert committee and comprised injection site pain, bone pain, grippal syndrome, fever, residual risk of FN with G-CSF, biosimilar use, injections number and cost per cycle. Eight scenarios were completed per participant for primary and secondary prophylaxis. A mixed-effect logit model estimated the preferences.
Results
205 participants, i.e. medical oncologists (60%), pulmonologists (20%), gastroenterologists (20%) completed the survey: male, 61%, with ≤10- (40.5%), 11-20 (36.1%), ≥21 (23.4%) years of experience in oncology and private (18%), public (73.2%) or mixed (8.8%) exercise. In primary prophylaxis, significant criteria focused on the safety profile (pain at the injection site as most avoided tolerance criterion), the total cycle costs and the biosimilar profile (p<0,001). The residual FN risk was not significant. In secondary prophylaxis, efficacy becomes a significant criterion of preference in addition to other criteria (p<0,001).
Conclusions
In primary prophylaxis, physicians' preferences for G-CSF are based on patients’ comfort and costs more than efficacy which comes into play in secondary prophylaxis. Use of a biosimilar is well accepted in both settings.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
MUNDIPHARMA.
Disclosure
All authors have declared no conflicts of interest.