HTAC Guidance: PNF Inclusion of Filgrastim 300 mcg/0.9 mL Solution (IV, SC), 0.9 mL Pre-filled Syringe

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Published on: March 14, 2023

(Updated as of 14 March 2023)

On 24 January 2023, the OIC-Secretary of Health (SOH) approved the Health Technology Assessment Council (HTAC) recommendation for the government financing of Filgrastim 300 mcg/0.9 mL solution (IV, SC), 0.9 mL pre-filled syringe, for the treatment of neutropenia in patients undergoing bone marrow transplantation and patients receiving myelosuppressive cancer chemotherapy through its minor inclusion in the Philippine National Formulary (PNF).

Based on the Department Circular No. 2022-0584, otherwise known as Amendment to the Department Circular 2022-0254 dated 05 April 2022 titled, “Updates on the HTAC Processing of Minor Inclusion,” the minor inclusion process is applicable to drugs already listed in the PNF, and therefore eligible for government financing, but are being applied for additional dosage strength, net content, immediate packaging, pack size or volume, and any other change that will not result in significant difference in terms of bioavailability and meaningful clinical outcomes with the PNF-listed health technology.

The HTAC considered the following developing its recommendation:

  • Only the net volume of the pre-filled syringe (PFS) that contains 300 mcg of filgrastim was changed from the previously PNF-included 0.5mL PFS to 0.9 mL PFS. Both dosage formulations contain 300 mcg of filgrastim; hence, the number of pre-filled syringes that will be consumed per dose will not differ.  
  • The unit price of filgrastim 300mcg/0.9mL solution for injection (IV/SC), 0.9mL pre-filled syringe is lower than the unit price of Filgrastim 300 mcg/0.5mL solution for injection (IV/SC), 0.5mL pre-filled syringe . 
  • Since the unit cost of the proposed dosage formulation is lower than the unit cost of the comparator (i.e., the currently listed form in the PNF) and there are no differences in the number of pre-filled syringes that will be consumed per patient per regimen, cost savings are expected with the use of the proposed filgrastim, 300 mcg/0.9 mL solution for injection (IV, SC), 0.9mL pre-filled syringe
    • For an average pediatric patient (30 kg patient*) with neutropenia due to concurrent myelosuppressive chemotherapy which is the widest indication for this drug, the cost savings (per patient) associated with the use of the new formulation with new net content are the following:
      • 5 mcg/kg/day for 10 days dosing regimen: ₱88,200.00 for the whole 6 cycles of chemotherapy
      • 5 mcg/kg/day for 14 days dosing regimen: ₱123,480.00 for the whole 6 cycles of chemotherapy
    • For an average adult patient (60 kg patient*) with neutropenia due to concurrent myelosuppressive chemotherapy which is the widest indication for this drug, the cost savings (per patient) associated with the use of the new formulation with new net content are the following:
      • 5 mcg/kg/day for 14 days dosing regimen: ₱123,480.00 for the whole 6 cycles of chemotherapy

*The average weights of patients were based on consultation with medical societies 

Link to the issuance: DC No. 2023-0061 

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