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Philippe Laplaige
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FP06 - Palliative and Supportive Care (ID 160)
- Event: WCLC 2020
- Type: Posters (Featured)
- Track: Palliative and Supportive Care
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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FP06.01 - Discrete Choice Experiment to Estimate Physicians’ Preferences in Terms of G-CSF use for Febrile Neutropenia Primary and Secondary Prophylaxis (ID 3119)
00:00 - 00:00 | Author(s): Philippe Laplaige
- Abstract
Introduction
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, Influenza-like illness (ILI), 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
Two hundred and five participants: 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 mainly focused on the injection number per cycle (coef. 0.212, p<10-4) and the total cost per cycle (coef. 0.1139, p<10-4), before the safety profile (pain at the injection site as most avoided tolerance criterion, (coef. 0.0768, p<10-4)) and the efficacy (coef. 0.039, p=0.0152). The biosimilar profile is well-received (coef. 0.1446 p<10-4). In secondary prophylaxis, efficacy became a more significant criterion of preference in addition to other criteria (coef. 0.0939, p<10-4).
Attributes
Primary prophylaxis
Secondary prophylaxis
Coefficient
p value
Coefficient
p value
Risk of febrile neutropenia
0.039
0.0152
0.0939
<10-4
Biosimilar
0.1446
<10-4
0.1102
<10-4
Cost/ cycle (€)
0.1139
<10-4
0.1056
<10-4
Injection number
0.212
<10-4
0.1368
<10-4
Injection site pain
0.0768
<10-4
0.0463
0.0054
Bone pain
-0.0402
0.0123
-0.072
<10-4
Influenza-like illness (ILI)/ fever
-0.0366
0.0228
-0.0512
0.0021
Log-Likelihood
-2130.81
-2246.5
Participant number
205
205
Conclusion
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.
