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Annals of Oncology Advance Access originally published online on December 13, 2007
Annals of Oncology 2008 19(3):454-460; doi:10.1093/annonc/mdm525
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© The Author 2007. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

supportive care

Cost of neutropenic complications of chemotherapy

D. Weycker1,*, J. Malin2, J. Edelsberg1, A. Glass3, M. Gokhale1 and G. Oster1

1 Policy Analysis Inc., Brookline, MA
2 Amgen Inc., Thousand Oaks, CA
3 Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA

* Correspondence to: Dr D. Weycker, Policy Analysis Inc., Four Davis Court, Brookline, MA 02445, USA. Tel: +1-617-232-4400; Fax: +1-617-232-1155; E-mail: dweycker{at}pai2.com

Background: Cost of neutropenic complications of myelosuppressive chemotherapy has been reported to be substantial. Prior research, however, has focused on initial hospitalization only and has failed to account for follow-on care.

Patients and methods: Using a US health-care claims database, all adult cancer patients who received a course of chemotherapy were identified. For each such patient, each unique cycle of chemotherapy within the course and each occurrence of neutropenic complications within these cycles were characterized. Patients developing neutropenic complications in a given cycle (neutropenia patients), starting with the first, were matched (1 : 1) to those who did not develop neutropenic complications in that cycle (comparison patients), and health-care costs (i.e. expenditures) were tallied for each matched pair.

Results: Neutropenia patients (n = 373) and comparison patients were similar in terms of baseline characteristics. Costs of neutropenia-related care were $12 397 (95% confidence interval $10 274–$14 754) higher for neutropenia versus comparison patients [$14 407 ($12 357–$16 743) versus $2010 ($1490–$2553)]. Among neutropenia patients, mean cost of initial hospitalization for neutropenic complications was $7813 ($6537–$9379); cost of all subsequent neutropenia-related care averaged $6594 ($5217–$8272).

Conclusions: Neutropenic complications of myelosuppressive chemotherapy are costly. Prior research focusing on initial hospitalization only may have underestimated the cost of these complications by as much as 40%.

Key words: costs and cost analysis, fever, infection, neoplasms, neutropenia

Received for publication January 25, 2007. Revision received August 28, 2007. Accepted for publication October 11, 2007.


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