search for


Cost-Utility Analysis of Pegfilgrastim and Pegteograstim in Patients with Breast Cancer using Doxorubicin and Cyclophosphamide
J. Kor. Soc. Health-syst. Pharm. 2018;35:409-417
Published online November 30, 2018;
© 2018 Korean Society of Health-System Pharmacists

Su Ji Kwona, Min Jung Geuma, Jae Song Kima, Eun Sun Sona and Kyeng Hee Kwonb,†

Department of Pharmacy, Severance Hospital, Yon-sei University Health System, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Koreaa
College of Pharmacy, Dongguk University, Dongguk University Biomedi Campus 32, Dongguk-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10326, Republic of Koreab
Correspondence to: Kyeng Hee Kwon, Tel:031-961-5216 Fax:031-961-5206,
Received February 8, 2018; Revised March 22, 2018; Accepted September 14, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background : Febrile neutropenia (FN) is one of the side effects in the patients treated with chemotherapy, and the patients who have FN generally need immediate treatment with extended-spectrum antibiotics and hospitalization. Pegfilgrastim and pegteograstim, which are used for the prevention of FN as a granulocyte-colony stimulating factor (G-CSF), have been granted insurance coverage in the Republic of Korea for certain breast cancer patients using doxorubicin and cyclophosphamide (AC) from September 2016.
Methods : The data of the patients with breast cancer using AC regimen and G-CSF were collected retrospectively. This study involves cost-utility analysis of pegfilgrastim and pegteograstim. In this study, we constructed a simple decision tree model for short-term observation and calculated quality-adjusted life year (QALY) and the direct medical costs from the medical provider’s perspective.
Results : From September 2016 to May 2017, 15 patients were treated with pegfilgrastim and 15 patients were treated with pegteograstim. As a result of dividing the average cost by QALY for each treatment group, it was observed that pegfilgrastim and pegteograstim were consumed 24,923,384 won and 22,808,336 won per 1QALY, respectively. Consequently, incremental cost effectiveness ratio (ICER) showed 2,115,048 won more per pegfilgrastim than pegteograstim per 1QALY, and the cost per 1QALY of both the drugs was lower than 30,500,000 won; the Koreans were willing to pay this amount.
Conclusions : This study suggests that pegfilgrastim and pegteograstim can be used to improve the quality of life of breast cancer patients undergoing AC therapy. Among the two drugs, pegteograstim seems to be more cost-effective. However, since this study was conducted as a retrospective observation method on a small scale, it is associated with many limitations. Therefore, a long-term prospective cohort study is needed to supplement the present findings.
Keywords : Febrile neutropenia, Breast cancer, Pegfilgrastim, Pegteograstim, Cost-utility analysis