The Scottish Medicines Consortium (SMC) has accepted filgrastim (Nivestim®) for use within NHS Scotland for the following indications:

• The 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);

• 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 mobilisation of peripheral blood progenitor cells (PBPC);

• In patients, children or 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;

• The 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 options to manage neutropenia are inappropriate.

Nivestim® is a biosimilar product and has demonstrated equivalence in terms of efficacy and safety to a reference granulocyte colony stimulating factor, filgrastim (Neupogen®).  For more detailed information on the evidence submitted by the manufacturer and considered by the SMC when making their recommendation, please see the drug advice at the link below.