Chemotherapy is a group of drugs that treat cancer. These drugs destroy both healthy and unhealthy fast-growing cells (like cancer). White blood cells (WBCs) are healthy cells that help prevent infection. neutrophils is an important white blood cell. They are monitored during chemotherapy with a blood test called a complete blood count (CBC).
Chemotherapy can cause a drop in neutrophil counts, leading to serious infections and delays in treatment.This low neutrophil count is called neutropenia. Fortunately, some medications help prevent neutropenia. For example, both Neulasta and Neupogen are injected after chemotherapy to help stimulate WBC production and reduce the chance of neutropenia.
This article will explain the difference between Neulasta and Neupogen.
How Neulasta and Neupogen Work
Both Neulasta and Neupogen are made from a natural protein called granulocyte-colony stimulating factor (or “G-CSF”). In humans, granulocyte-colony stimulating factor is responsible for increasing the production and release of neutrophils in the bone marrow.
Neulasta (common name pegfilgrastim) has polyethylene glycol, “PEG” units are added to it. This larger “PEG” molecule stays in your system longer than Neupogen (filgrastim). Because Neulasta stays in the body longer, it requires fewer doses to be effective.
It’s important to note that not all chemotherapy requires Neulasta or Neupogen. Your oncologist will discuss your need for G-CSF.
number of injections required
Give Neulasta at least 24 hours back each chemotherapy cycle. The chemotherapy cycle depends on the treatment plan prescribed to you.
Some patients go home with a device that automatically delivers Neulasta at the correct date and time. This device is called an on-body injector (OBI). Before you leave the clinic, the infusion nurse will program the OBI and attach it to your arm.
If this device is not available, you will return to the clinic 24 hours after chemotherapy to receive the injection. Neulasta should not be administered more frequently than once every 14 days.
Neupogen is also started 24 hours after chemotherapy. However, in contrast to Neulasta, it is administered daily for several days. Factors such as your neutrophil count, type of treatment, and medical condition help determine how many injections of Neupogen you need per day. Although this medication is not available as an OBI, you can use it yourself at home.
Although both Neulasta and Neupogen have been shown to be effective in reducing neutropenia, clinical trials suggest that Neulasta may have the upper hand.
A systematic review study looked at multiple previous studies and found that long-acting G-CSF, such as Neulasta, has better efficacy and efficacy than short-acting equivalents such as Neupogen. In addition, Neulasta is more convenient to administer as a one-time single dose.
Bone pain is probably the most significant side effect of G-CSF. One study found that about 30 percent of patients receiving Neulasta experienced bone pain, compared with 24 percent of those receiving Neupogen. Bone pain occurs due to swelling of the bone marrow when white blood cells are stimulated to multiply.
Nonsteroidal anti-inflammatory drugs (NSAIDs) have been shown to be more effective than narcotics in treating bone pain. There is also growing evidence that Claritin (loratadine) may be a useful option for bone pain relief.
Patients with certain blood cancers should avoid G-CSF because these drugs may make the condition worse by triggering the growth of cancer cells.
Other potential side effects include:
- spleen rupture
- a serious lung disease called ARDS
- sickle cell crisis
- kidney damage
- increase in white blood cells
- decreased platelet count
- capillary leak syndrome
- secondary cancer
- Aortic inflammation
Allergic reactions can occur with both Neulasta and Neupogen. Some health care providers require you to receive your first dose at the clinic and observe for 30 minutes after the injection.
prevent an infection
It’s important to remember that your risk of infection increases even though You are receiving Neulasta or Neupogen. If you have a fever (100.4 F or higher) at any time, you must contact your oncology team immediately. Neutropenia is considered a medical emergency and needs to be treated as soon as possible.
Learning to reduce your risk of infection during cancer treatment is critical to your health and well-being during this journey.
Cost of Neulasta and Neupogen
Neulasta is by far more expensive than Neupogen. However, the dose of Neupogen required increases rapidly. Despite these high prices, a single hospitalization for severe neutropenia and infection is undoubtedly more expensive.
Here are the current costs for both drugs, according to GoodRx.com:
- A single 6-mg injection of Neulasta will cost $6,000 to $7,000, depending on the supplier.
- A 300-microgram injection of Neupogen will cost $300 to $350, depending on the supplier.
Will insurance pay for it?
While most insurance companies, including government programs such as Medicare or Medicaid, cover the cost of Neulasta and Neupogen, Amgen (the maker of both drugs) offers a variety of payment options through its Amgen ASSIST 360 plan.
- Commercially insured patients who need a reduced co-payment fee may be eligible for the Amgen First Step Program.
- Those with government insurance can be referred to an independent, not-for-profit patient assistance program that helps reduce affordability and co-pays.
- For uninsured patients, the Amgen Safety Net Foundation is a nonprofit patient assistance program that helps access Amgen medicines for free.
Additionally, many oncology clinics have social workers, financial counselors, and pharmacists who can help patients get the medicines they need for free or at low cost. It’s important to be your own advocate and ask questions until you’re fully informed.
If your insurance company does not agree to cover any drugs you need, ask your healthcare provider to advocate on your behalf.
Depending on your insurance coverage, Neupogen can be used at home for less money. For your convenience, injections are delivered directly to your residence.
Your oncology nurse or pharmacist will teach you or your caregiver how to give injections properly. You will also get a small sharps container to hold your used syringe. Bring the container to your next oncology visit and they can dispose of it properly.
Cancer treatment is expensive, which can lead to increased stress and anxiety. After a diagnosis, meeting with your healthcare organization’s financial counselor can get you the support you need faster. Plus, being creative and thinking outside the box can help save time and money in the long run.
Both Neulasta and Neupogen can significantly reduce the risk of infection during chemotherapy. They work by increasing the levels of a type of immune cell called neutrophils. If you develop a fever or other signs of infection, such as chills, during cancer treatment, call your oncology team right away.
Neupogen is short-acting, while Neulasta stays in the system longer. There is some evidence that Neulasta is more effective.
Bone pain is a common side effect of both drugs. Before starting G-CSF, talk to your oncology nurse about reducing bone pain. Taking Claritin before and a few days after the injection may reduce bone pain.
Finally, ask to speak with your oncology clinic’s financial counselor as soon as possible. They can review your health insurance benefits and help identify plans that can lower the cost of drugs like Neulasta and Neupogen.
Frequently Asked Questions
Which is better Neulasta or Neupogen?
While some studies suggest Neulasta may be more effective, factors such as cost, convenience, bone pain, neutrophil count, treatment options, and your medical condition all play a role in determining the best option.
Can Neulasta or Neupogen be given at home?
Depending on your insurance coverage and availability, Neupogen can be used at home.
How long will bone pain last after Neulasta and Neupogen?
Bone pain usually occurs between 12 and 18 hours after the injection and can last 1 to 4 days. Some research suggests that taking Claritin daily during this time can help reduce bone pain.