Va Hospitals: Neulasta And Neupogen Options

Neulasta and Neupogen are drugs administered after chemotherapy to stimulate white blood cell (WBC) production and prevent neutropenia, a condition where the body has a low count of neutrophils, a type of WBC that prevents infection. Neutropenia can cause serious infections and delays in chemotherapy treatment. Neulasta and Neupogen are both made of a natural protein called granulocyte-colony stimulating factor (G-CSF) and are considered colony activity stimulators. While both drugs are effective, Neulasta has been shown in clinical trials to be more effective and convenient to administer, requiring fewer doses due to its longer-lasting effects. However, it is significantly more costly than Neupogen. This article will explore the VA Hospital's use of Neulasta and Neupogen, including their efficacy, safety, and cost implications for patients and the healthcare system.

Neulasta and Neupogen are both used to stimulate white blood cell production after chemotherapy

Neulasta (pegfilgrastim) and Neupogen (filgrastim) are both medications used to stimulate white blood cell production after chemotherapy. Chemotherapy destroys both healthy and unhealthy fast-growing cells, including white blood cells (WBCs), which are essential for preventing infections. This reduction in WBCs can result in neutropenia, a condition characterised by low levels of neutrophils, a specific type of WBC. Neulasta and Neupogen are made of a natural protein called granulocyte-colony stimulating factor (G-CSF), which increases the production and release of neutrophils from the bone marrow.

Neulasta and Neupogen are both administered via injection, with Neulasta given at least 24 hours after each chemotherapy cycle, and Neupogen started 24 hours after chemotherapy and then administered daily for several consecutive days. Neulasta has a longer duration of action compared to Neupogen due to the addition of a polyethylene glycol (PEG) unit, which means it can remain in the body for longer and requires fewer doses. Neupogen, on the other hand, offers more flexibility in treatment plans and may have a lower risk of causing bone pain as a side effect due to its shorter duration of action.

Both medications can effectively reduce the risk of infection during chemotherapy by increasing WBC levels. Clinical trials suggest that Neulasta may be more effective in decreasing neutropenia, and it is also more convenient as it only requires a single dose per chemotherapy cycle. However, Neupogen has broader applications and can be used not only for patients undergoing chemotherapy but also for those having bone marrow transplants or peripheral blood progenitor cell collection and therapy.

The cost of these medications can be high, with Neulasta injections ranging from $6,000 to $7,000 per dose and Neupogen injections costing between $300 and $350. However, most insurance companies, including government programs, typically cover the cost of these medications. Additionally, the drug manufacturers offer payment assistance programs to help make these treatments more accessible to patients.

Neulasta is more costly than Neupogen, but fewer doses are needed

Neulasta (pegfilgrastim) and Neupogen (filgrastim) are both medications used to stimulate the production of white blood cells in patients undergoing chemotherapy. Chemotherapy can cause a drop in the neutrophil count, resulting in serious infections and delays in treatment. This condition is called neutropenia, and both Neulasta and Neupogen are effective at reducing its occurrence.

Neulasta and Neupogen have different pharmacokinetic profiles, which result in different dosing requirements. Neulasta has a polyethylene glycol ("PEG") unit added to it, which makes the molecule larger and allows it to stay in the body longer than Neupogen. As a result, Neulasta requires fewer doses to be effective. Neulasta is typically administered as a single 6 mg subcutaneous injection per chemotherapy cycle, at least 24 hours after chemotherapy. In contrast, Neupogen is a short-acting medication and is usually given daily for several days after chemotherapy, with the dosage adjusted based on the patient's response.

The cost of Neulasta is significantly higher than that of Neupogen. A single injection of Neulasta can cost between $6,000 and $7,000, while a Neupogen injection ranges from $300 to $350. However, it is important to consider that the required doses of Neupogen can quickly add up, potentially making it more expensive overall. Additionally, the cost should not be the primary consideration when choosing between these medications, as the effectiveness and suitability of the treatment for each patient should be prioritized.

Both Neulasta and Neupogen are covered by most insurance companies, including government programs such as Medicare and Medicaid. The manufacturer, Amgen, also offers payment assistance programs for patients who need help with co-pay costs. It is recommended that patients speak with their oncology clinic's financial counselor to review their insurance benefits and explore options for reducing medication costs.

Neupogen is started daily for several days after chemotherapy

Neupogen (filgrastim) is an injection administered to stimulate white blood cell (WBC) production and reduce the risk of neutropenia, which is a common side effect of chemotherapy. Chemotherapy targets fast-growing cells, including healthy cells such as white blood cells, and can cause a drop in the neutrophil count, resulting in serious infections and treatment delays.

Neupogen is typically started 24 hours after chemotherapy and is given daily for several consecutive days. The number of daily injections required is determined by factors such as the patient's neutrophil count, treatment type, and medical condition. Neupogen is short-acting, and its effect may not last long, which is why it is administered daily over a period of time. It is important to note that Neupogen may not be available as an on-body injector (OBI), but patients may be able to self-administer it at home.

While Neupogen can be effective in reducing the risk of infection during chemotherapy, it is essential to monitor the patient's health and seek medical attention if any signs of infection, such as fever or chills, occur during treatment. Additionally, bone pain is a common side effect of Neupogen, and patients are advised to consult their oncology team to discuss methods to alleviate this pain.

The cost of Neupogen injections can range from $300 to $350 per 300-microgram injection, and most insurance companies, including government programs, typically cover the expense. However, patients should consult their insurance providers to understand their specific coverage and explore options for financial assistance if needed.

Neulasta is administered as a one-time, single dose

Neulasta (pegfilgrastim) is a medication that helps to prevent neutropenia, a condition where the body has a low neutrophil count, which are white blood cells that prevent infection. Neutropenia can be caused by chemotherapy, which destroys both healthy and unhealthy fast-growing cells. Neulasta is administered to stimulate white blood cell production and reduce the chance of infection.

Neulasta is given as an injection under the skin, either by a healthcare professional, or it can be self-administered at home. It can also be delivered via an on-body injector (OBI), which is a device that automatically delivers the drug at the correct time. The OBI is filled by a healthcare professional and then attached to the patient's skin, usually on the arm or abdomen. The drug is then delivered approximately 27 hours later over a 45-minute period.

Neulasta is typically given at least 24 hours after each chemotherapy cycle, and it should not be administered more frequently than every 14 days. It is important to note that Neulasta should not be given within 14 days before or 24 hours after chemotherapy treatment. The recommended dosage is a single injection of 6 mg, which is the only available strength.

Neulasta is more expensive than its counterpart, Neupogen, with one injection costing between $6,000 and $7,000. However, Neupogen may require multiple doses, and the cost of hospitalization for severe neutropenic fever and infection is much higher. Additionally, Neulasta is more convenient as it only requires a one-time, single dose, whereas Neupogen is given daily for several days. This makes Neulasta a more effective and efficient treatment option for neutropenia.

Neupogen may be self-administered at home

Neupogen (filgrastim) is a medication used to decrease the chance of infection in people with non-myeloid cancer who are receiving chemotherapy. It is also used to increase the number of white blood cells, reduce the length of time with fever in people with acute myeloid leukemia, and prepare the blood for leukapheresis. Neupogen can be given by intravenous (IV) infusion or injected under the skin (subcutaneous injection).

Neupogen is typically started 24 hours after chemotherapy and is given daily for several consecutive days. It is important to note that the number of daily injections required depends on factors such as neutrophil count, treatment type, and medical condition. A healthcare provider will determine the dosage and demonstrate how to properly administer Neupogen at home. This includes instructing patients on where to inject the medication and providing guidance on avoiding injection into the same place twice in a row or into areas of tender, bruised, red, or hard skin.

While Neupogen can be self-administered at home, it is crucial to follow the prescribed dosage and not make any changes without medical advice. Patients should also be aware of potential side effects, such as an enlarged spleen, and seek immediate medical attention if they experience left-sided upper stomach pain or left shoulder pain. Additionally, Neupogen should be stored in its original container in the refrigerator, away from light, and allowed to reach room temperature before use.

Neupogen is generally well-tolerated, but it is important to monitor neutrophil counts during treatment. Discontinuation of Neupogen may be recommended if the white blood cell count rises above a certain threshold. While Neupogen has proven effective in reducing neutropenia, Neulasta, a similar medication, may offer some advantages due to its longer duration of action and potentially greater efficacy. However, Neulasta is significantly more costly than Neupogen, and the decision between the two medications should be made in consultation with a medical professional.

Frequently asked questions