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PrNeulasta® Reimbursement
Neulasta® (pegfilgrastim)
DIN 02249790
Neulasta® is an eligible benefit through most private insurance plans, and through some provincial/ territorial drug benefit programs and federal drug plans. Please choose the appropriate drug plan/program from the sidebar menu for specific information on Neulasta® reimbursement.
Indication:
Neulasta® (pegfilgrastim) is indicated to decrease the incidence of infection, as manifested by febrile neutropenia, in patients with non-myeloid malignancies receiving myelosuppressive anti-neoplastic drugs.
Pediatrics (< 18 years of age): The safety and effectiveness of Neulasta® in pediatric patients have not been established.
Neulasta® is contraindicated in patients with known hypersensitivity to E. coli-derived proteins, pegfilgrastim, filgrastim, or any other component of the product. Neulasta® should not be used for PBPC (peripheral blood progenitor cell) mobilization. Very rare cases of splenic rupture, including some fatal cases, have been reported following the administration of Neulasta® (pegfilgrastim) and its parent compound (filgrastim).
The safety and efficacy of Neulasta® administered concurrently with cytotoxic chemotherapy have not been established. Because of the potential for an increase in sensitivity of rapidly dividing myeloid cells to cytotoxic chemotherapy‚ Neulasta® should not be administered in the period between 14 days before and 24 hours after administration of cytotoxic chemotherapy.
The safety and efficacy of Neulasta® have not been evaluated in patients receiving chemotherapy associated with delayed myelosuppression (e.g., nitrosoureas), mitomycin C, or myelosuppressive doses of anti-metabolites such as 5-fluorouracil (5-FU). The safety and efficacy of Neulasta® have not been evaluated in patients receiving radiation therapy.
Randomized studies have demonstrated that treatment with filgrastim following chemotherapy for acute myeloid leukemia (AML) does not adversely influence the outcome of treatment. The use of Neulasta® in AML, chronic myeloid leukemia (CML) and myelodysplasia (MDS) has not been studied.
Severe sickle cell crises have been associated with the use of Neulasta® in patients with sickle cell disorders. Severe sickle cell crises, in some cases resulting in death, have also been associated with filgrastim, the parent compound of pegfilgrastim. Only physicians qualified by specialized training or experience in the treatment of patients with sickle cell disorders should prescribe Neulasta® for such patients, only after careful consideration of the potential risks and benefits.
Allergic-type reactions, including anaphylaxis, skin rash, urticaria and erythema/flushing occurring on initial or subsequent treatment have been reported both with Neulasta® and filgrastim. Acute respiratory distress syndrome (ARDS) has been reported following administration of Neulasta® and is postulated to be secondary to an influx of neutrophils to sites of inflammation in the lungs. Neutropenic patients receiving Neulasta® who develop fever, lung infiltrates, or respiratory distress should be evaluated for the possibility of ARDS. A complete blood count (CBC) and platelet count should be obtained before chemotherapy is administered. Regular monitoring of hematocrit value, white blood cell count and platelet count is recommended.
In clinical trials comparing Neulasta® to filgrastim, medullary bone pain was reported in 26% of Neulasta®-treated patients, which was comparable to the incidence in filgrastim-treated patients. In the study comparing Neulasta® to placebo, the incidence of bone pain was 23% vs. 16%, respectively. This bone pain was generally reported to be of mild-to-moderate severity. No patient withdrew from study due to bone pain.
Please refer to product monograph for complete dosing and safety information.
Neulasta® Product Monograph
Resources for Healthcare Professionals and Patients
The following websites are external links. DrugCoverage asssumes no responsibility for the content of these sites.
National Comprehensive Cancer Network (NCCN) Website (requires password / login)
Once logged in, click on NCCN Clinical Practice Guidelines in OncologyTM.
Scroll down to "guidelines for Supportive Care" to find:
Myeloid Growth Factors V.1. 2011
2006 Update of Recommendations for the Use of White Blood Cell Growth Factors: An Evidence Based Clinical Practice Guideline
Smith, Thomas J., Khatcherssian, James, Lyman, Gary H. (2006)
Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology, 24 (19): 3187 - 3205
Amgen Canada's VICTORYTM Program provides reimbursement information and assistance 24 hours a day, 7 days per week to patients with a prescription for Neulasta ®. Financial assistance may be available to eligible patients in accordance with criteria established by the VictoryTM Program, which may change at anytime without prior notice in the Program's sole discretion. Call 1-888-706-4717 to enroll.
VICTORYTM Program Patient Enrollment Form
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