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The American Journal of Managed Care October 2016
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Estimating the Social Value of G-CSF Therapies in the United States
Jacqueline Vanderpuye-Orgle, PhD; Alison Sexton Ward, PhD; Caroline Huber, MPH; Chelsey Kamson, BS; and Anupam B. Jena, MD, PhD
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Estimating the Social Value of G-CSF Therapies in the United States

Jacqueline Vanderpuye-Orgle, PhD; Alison Sexton Ward, PhD; Caroline Huber, MPH; Chelsey Kamson, BS; and Anupam B. Jena, MD, PhD
Granulocyte-colony stimulating factors (G-CSFs) reduce the risk of febrile neutropenia in patients with cancer. This study evaluates the clinical and nonclinical value associated with G-CSFs.
This study estimates that 314,442 patients with cancer were potential candidates for prophylactic G-CSFs in the United States in 2014. Based on the parameters and assumptions used in our calculations, G-CSFs generated a total of almost $8.5 billion in SV. More than 97% of this value was attributable to estimated improvements in clinical outcomes. Importantly, reductions in overall mortality from both reduced FN hospitalizations and chemotherapy dose reductions avoided accounted for $10 billion in SV. Since we found few studies that investigated improvements in nonclinical outcomes associated with G-CSFs, our SV estimate of $232 million may be a conservative lower bound for the total nonclinical value.

By considering all possible benefits of G-CSFs, our study results suggest these therapies provide substantial value for society, particularly for patients. The portion of value accruing to manufacturers in the form of profits is approximately 15%. These estimates are similar to previous work that suggests that between 5% and 19% of the value generated by gains in cancer survival have been appropriated by manufacturers in the form of profits.47 Our analysis further demonstrates the need to evaluate the cost-effectiveness of medical innovations in a way that incorporates broader impacts to society, such as nonclinical benefits.  Failure to include these components can significantly underestimate the economic value of medical innovations and the value to patients. 

Author Affiliations: Precision Health Economics (JV-O, ASW, CH, CK), Los Angeles, CA; Harvard Medical School, Department of Health Care Policy (ABJ), Boston, MA.

Source of Funding: This study was supported by Amgen, Inc.

Author Disclosures: Drs Vanderpuye-Orgle and Sexton, Ms Huber, and Ms Kamson are employees of Precision Health Economics (PHE), which was compensated by Amgen to conduct the study. Dr Jena is a consultant at PHE.

Authorship Information: Concept and design (ABJ, ASW, JV-O); acquisition of data (CH, ABJ, CK, ASW); analysis and interpretation of data (CH, ABJ, ASW, JV-O); drafting of the manuscript (CH, ABJ, CK, ASW, JV-O); critical revision of the manuscript for important intellectual content (CH, ABJ, JV-O, ASW); statistical analysis (ABJ, ASW); provision of patients or study materials (ASW, JV-O); obtaining funding (ASW, JV-O); administrative, technical, or logistic support (CK); and supervision (ABJ, JV-O).

Address Correspondence to: Anupam B. Jena, MD, PhD, Harvard Medical School, Department of Health Care Policy, 180 Longwood Ave, Boston, MA 02115-5899. E-mail: jena@hcp.med.harvard.edu.
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