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Objectives <p>To evaluate the cost-effectiveness of pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) versus recombinant human granulocyte colony-stimulating factor (rhG-CSF) for primary prophylaxis of chemotherapy-induced neutropenia (CIN) among patients with non-Hodgkin lymphoma (NHL) treated with R-CHOP.</p> Methods <p>We developed two linked state-transition (Markov) models to estimate clinical and economic outcomes: a chemotherapy-phase model (18 weeks) and a post-chemotherapy model with a 20-year time horizon. Costs and selected transition probabilities were informed by real-world data from the Jiangsu Provincial Public Health Information Platform (a regional multicenter database); remaining inputs were obtained from the published literature. Parameter uncertainty was explored using deterministic one-way sensitivity analysis (DSA) and probabilistic sensitivity analysis (PSA).</p> Results <p>In the base-case analysis, rhG-CSF was associated with lower total costs ($17,299.41 vs. $17,947.88) and slightly higher effectiveness (7.75 vs. 7.74 QALYs) compared with PEG-rhG-CSF. At a willingness-to-pay (WTP) threshold of one times China’s per capita GDP in 2024 ($13,581.42 per QALY), PEG-rhG-CSF yielded a negative incremental net monetary benefit (iNMB: −$739.55), indicating that rhG-CSF was the economically preferred strategy. Deterministic and probabilistic sensitivity analyses demonstrated that the base-case findings were generally robust across plausible variations in model parameters. The probability that rhG-CSF was cost-effective relative to PEG-rhG-CSF remained above 60% across a range of WTP thresholds.</p> Conclusions <p>Based on real-world data and economic modeling, rhG-CSF showed a slightly higher probability of being cost-effective than PEG-rhG-CSF for primary prophylaxis of CIN among patients with NHL treated with R-CHOP.</p>

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Cost effectiveness analysis of PEG-rhG-CSF versus rhG-CSF for primary prophylaxis of chemotherapy induced neutropenia in Chinese patients with non-Hodgkin lymphoma using real world data

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月7日

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  • Yiwen Zhu,
  • Ying Qu,
  • Ke Ding,
  • Rong Chen

摘要

Objectives

To evaluate the cost-effectiveness of pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) versus recombinant human granulocyte colony-stimulating factor (rhG-CSF) for primary prophylaxis of chemotherapy-induced neutropenia (CIN) among patients with non-Hodgkin lymphoma (NHL) treated with R-CHOP.

Methods

We developed two linked state-transition (Markov) models to estimate clinical and economic outcomes: a chemotherapy-phase model (18 weeks) and a post-chemotherapy model with a 20-year time horizon. Costs and selected transition probabilities were informed by real-world data from the Jiangsu Provincial Public Health Information Platform (a regional multicenter database); remaining inputs were obtained from the published literature. Parameter uncertainty was explored using deterministic one-way sensitivity analysis (DSA) and probabilistic sensitivity analysis (PSA).

Results

In the base-case analysis, rhG-CSF was associated with lower total costs ($17,299.41 vs. $17,947.88) and slightly higher effectiveness (7.75 vs. 7.74 QALYs) compared with PEG-rhG-CSF. At a willingness-to-pay (WTP) threshold of one times China’s per capita GDP in 2024 ($13,581.42 per QALY), PEG-rhG-CSF yielded a negative incremental net monetary benefit (iNMB: −$739.55), indicating that rhG-CSF was the economically preferred strategy. Deterministic and probabilistic sensitivity analyses demonstrated that the base-case findings were generally robust across plausible variations in model parameters. The probability that rhG-CSF was cost-effective relative to PEG-rhG-CSF remained above 60% across a range of WTP thresholds.

Conclusions

Based on real-world data and economic modeling, rhG-CSF showed a slightly higher probability of being cost-effective than PEG-rhG-CSF for primary prophylaxis of CIN among patients with NHL treated with R-CHOP.