G-CSF spending: Cost Impact of an intervention conducted in a French area: Pays-de-la-Loire

Abstract

Abstract Issue Granulocyte colony-stimulating factors (G-CSF), recommended by international oncology guidelines as a prophylaxis of febrile neutropenia are expensive drugs. Despite biosimilars marketing since 2008, G-CSF spending represents a major and growing expense for health insurance. Description of the problem Between 2010 and 2013 an unsustainable increase of G-CSF spending by 20% occurred in a French area: Pays-la-Loire. An intervention based on guidelines was carried out to the oncologists involved in ambulatory cancer care to reduce G-CSF spending by improving prescription and promoting biosimilars. Hospital oncologists have been the main target. A partnership between physicians and pharmacists of the Brittany - Pays-de-la-Loire Cancer Dedicated Observatory network and the Pays de la Loire Medical Department of Health insurance composed the operational team involved in the work. Interrupted time series analysis based on the French national health data system database were chosen to assess the impact of the intervention on G-CSF spending, their prescription and biosimilars use. Results Twelve professional meetings were performed to cancer medical teams from 7 community hospitals and 5 private hospitals of the Pays-de-la-Loire region. This intervention reduced G-CSF spending by 11% and improves G-CSF local use. Lessons This type of multi-stakeholder intervention carrying common to various health actor’s messages represents a promising tool to improve the quality of care and the control of health expenditure. These results and the possible cost saving showed have encouraged the heads of French health insurance to promote this action in 2019 in the whole France. Key messages In the current context of unsustainable increases in cancer cares related costs in France the rational use of G-CSF’s seemed to be one available resources. biosimilar promotion for ensure broad access to innovative cancer therapeutic for patients and finance cancer prevention campaigns.