Retrospective cost analysis of management of febrile neutropenia in cancer patients in Spain
| Autor: | José Ignacio, Mayordomo, Andrés, López, Núria, Viñolas, Javier, Castellanos, Sonia, Pernas, Juan, Domingo Alonso, Adolfo, Frau, Miquel, Layola, José, Antonio Gasquet, Jordi, Sánchez, M J, Lamas |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty Neutropenia Fever medicine.medical_treatment Antineoplastic Agents Indirect costs Pharmacotherapy Internal medicine Neoplasms Medicine Humans Lung cancer Aged Retrospective Studies Chemotherapy business.industry Cancer Retrospective cohort study General Medicine Middle Aged medicine.disease Surgery Hospitalization Spain Costs and Cost Analysis Female business Febrile neutropenia |
| Zdroj: | Current medical research and opinion. 25(10) |
| ISSN: | 1473-4877 |
| Popis: | Febrile neutropenia (FN) is associated with disruption of planned chemotherapy and increased management costs. However, the economic impact of FN in Spanish clinical practice has not been documented hitherto.A multicenter, retrospective chart review of adults with breast or lung cancer or non-Hodgkin's lymphoma (NHL) who hador = 1 FN episode during chemotherapy. Resource use, direct costs, and FN effect on planned chemotherapy were assessed.238 episodes of FN were analyzed in 194 patients. The mean + or - SD length of FN-related hospitalization was 8.7 + or - 6.9 days (median [p(25)-p(75)] = 7 [5-11] days). At least one transfusion was needed in 77 (32.3%) FN episodes, blood tests were done in 233 (97.9%) and blood cultures in 207 (87.0%). Antibiotics were used in all episodes (100%), other drugs in 186 (78.2%) episodes and the granulocyte colony-stimulating factor (G-CSF) in 161 (67.7%) episodes. The distribution of costs per episode of FN were: hospitalization 79%, antibiotics 10%, G-CSF 5%, complementary tests 4%; other drugs 1%, blood transfusions 1%. The estimated mean (95% CI) cost per FN episode was euro3841 (95% CI: euro3476-4206). FN management was costlier in NHL patients euro4514 (95% CI: euro3805-5223) than in breast or lung cancer patients (euro3519 [95% CI: euro2976-4061] and euro3311 [95% CI: euro2817-3805] respectively) (P0.05 both comparisons). Planned chemotherapy was disrupted in 139 (58.4%) episodes (dose reductions in 75 [34.9%], dose delays in 60 [28.0%] and withdrawal in 33 [14.7%]).FN substantially affects healthcare resource use and costs in breast cancer, lung cancer and, NHL. In this study, hospitalization and antibiotics were the main drivers of cost. A limitation of the analysis was that it did not include the indirect costs associated with FN episodes. |
| Databáze: | OpenAIRE |
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