Febrile neutropenia prophylaxis, G-CSF physician preferences: discrete-choice experiment - Université Paris-Est-Créteil-Val-de-Marne Access content directly
Journal Articles BMJ Palliative and supportive care Year : 2021

Febrile neutropenia prophylaxis, G-CSF physician preferences: discrete-choice experiment


Objectives Febrile neutropenia (FN) commonly occurs during cancer chemotherapy. Prophylaxis with granulocyte colonystimulating factors (G-CSFs) is known to reduce the severity and incidence of FN and infections in patients with cancer. Despite the proven efficacy, G-CSFs are not always prescribed as recommended. We performed a discretechoice experiment (DCE) to determine what factors drive the physician preference for FN prophylaxis in patients with cancer undergoing chemotherapy. Methods Attributes for the DCE were selected based on literature search and on expert focus group discussions and comprised pain at the injection site, presence of bone pain, associated fever/influenza syndrome, efficacy of prophylaxis, biosimilar availability, number of injections per chemotherapy cycle and cost. Oncologists, in a national database, were solicited to participate in an online DCE. The study collected the responses to the choice scenarios, the oncologist characteristics and their usual prescriptions of G-CSFs in the context of breast, lungs and gastrointestinal cancers. Results Overall, the responses from 205 physicians were analysed. The physicians were mainly male (61%), with ≤20 years of experience (76%) and working only in public hospitals (73%). The physicians prescribe G-CSF primary prophylaxis for 32% of patients: filgrastim in 46% and pegfilgrastim in 54%. The choice of G-CSF for primary and secondary prophylaxis was driven by cost and number of injections. Biosimilars were well accepted. Conclusion Cost and convenience of G-CSF drive the physician decision to prescribe or not G-CSF for primary and secondary FN prophylaxes. It is important that these results be incorporated in the optimisation of G-CSF prescription in the clinical setting.
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Dates and versions

hal-04142084 , version 1 (26-06-2023)



Florian Scotte, Hélène Simon, Philippe Laplaige, Eric-Charles Antoine, Caroline Spasojevic, et al.. Febrile neutropenia prophylaxis, G-CSF physician preferences: discrete-choice experiment. BMJ Palliative and supportive care, 2021, bmjspcare-2021-003082. ⟨10.1136/bmjspcare-2021-003082⟩. ⟨hal-04142084⟩
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