filgrastim (Zarzio)

following a full submission

filgrastim (Zarzio®) is accepted for use within NHS Scotland.

Indications under review:

• Reduction in the duration of neutropenia and the incidence of febrile neutropenia in patients treated with established cytotoxic chemotherapy for malignancy (with the exception of chronic myeloid leukaemia and myelodysplastic syndromes) and reduction in the duration of neutropenia in patients undergoing myeloablative therapy followed by bone marrow transplantation considered to be at increased risk of prolonged severe neutropenia. The safety and efficacy of filgrastim are similar in adults and children receiving cytotoxic chemotherapy.
• Mobilisation of peripheral blood progenitor cells (PBPC).
• In children and adults with severe congenital, cyclic, or idiopathic neutropenia with an absolute neutrophil count (ANC) of ≤ 0.5 x 109/l, and a history of severe or recurrent infections, long term administration of filgrastim is indicated to increase neutrophil counts and to reduce the incidence and duration of infection-related events.
• Treatment of persistent neutropenia (ANC ≤ 1.0 x 109/l) in patients with advanced HIV infection, in order to reduce the risk of bacterial infections when other therapeutic options are inappropriate.

Filgrastim (Zarzio®) is a biosimilar product to a reference granulocyte colony stimulating factor, filgrastim (Neupogen®).  The British National Formulary advises that it is good practice to prescribe biological medicinal products by brand name.

Other granulocyte colony stimulating factor products are available at lower cost.