PMU-Autor/inn/en
Jacobs VolkerAbstract
Background: Febrile neutropenia/leukopenia (FN/FL) is the most frequent dose-limiting toxicity of myelosuppressive chemotherapy, but German data on economic consequences are limited. Patients and Methods: A prospective, multicentre, longitudinal, observational study was carried out to evaluate the occurrence of FN/FL and its impact on health resource utilization and costs in non-small cell lung cancer (NSCLC), lymphoproliferative disorder (LPD), and primary breast cancer (PBC) patients. Costs are presented from a hospital perspective. Results: A total of 325 consecutive patients (47% LPD, 37% NSCLC, 16% PBC; 46% women; 38% age >= 65 years) with 68 FN/FL episodes were evaluated. FN/FL occurred in 22% of the LPD patients, 8% of the NSCLC patients, and 27% of the PBC patients. 55 FN/FL episodes were associated with at least 1 hospital stay (LPD n = 34, NSCLC n = 10, PBC n = 11). Mean (median) cost per FN/FL episode requiring hospital care amounted to (sic) 3,950 ((sic) 2,355) and varied between (sic) 4,808 ((sic) 3,056) for LPD, (sic) 3,627 ((sic) 2,255) for NSCLC, and (sic) 1,827 ((sic) 1,969) for PBC patients. 12 FN/FL episodes (LPD n = 9, NSCLC n = 3) accounted for 60% of the total expenses. Main cost drivers were hospitalization and drugs (60 and 19% of the total costs). Conclusions: FN/FL treatment has economic relevance for hospitals. Costs vary between tumour types, being significantly higher for LPD compared to PBC patients. The impact of clinical characteristics on asymmetrically distributed costs needs further evaluation.
Useful keywords (using NLM MeSH Indexing)
Aged
Breast Neoplasms/economics*
Breast Neoplasms/epidemiology
Carcinoma, Non-Small-Cell Lung/economics*
Carcinoma, Non-Small-Cell Lung/epidemiology
Comorbidity
Female
Fever/economics*
Fever/epidemiology
Germany/epidemiology
Health Care Costs/statistics*
numerical data*
Humans
Incidence
Lung Neoplasms/economics*
Lymphoproliferative Disorders/economics*
Lymphoproliferative Disorders/epidemiology
Male
Middle Aged
Neutropenia/economics*
Neutropenia/epidemiology
Prospective Studies
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Costs and cost analysis