Abstract P1-09-04: Taxanes in Metastatic Breast Cancer: Claims Analysis of Neutropenia, Infections, and CSF Costs

Abstract

Background: The taxanes (paclitaxel {Taxol} docetaxel {Taxotere} and nab paclitaxel {Abraxane}) are used in women with Results Figure 1 Hazard ratio for neutropenia Figure 2 Hazard ratio for infections

Comparison of Actual Hospital Costs versus DRG Revenues for In-Patient Treatment of Febrile Neutropenia during Adjuvant Anthracycline plus/minus Taxane-Based Chemotherapy for Primary Breast Cancer

“…In this study actual costs and DRG revenues of in-patient treatment for FN in pBC were compared for the German DRGsystemforthefirsttime [12].Modelsbasedonqualityadjusted life years (QALYs) for determining cost-effectivenessofprophylaxismedicationforFN [16]haveonlylimited valuefromtheprovider'sperspective.Usually,FNcosts,outcomesandtheirimplicationsareinvestigated [17][18][19].Butthe mandatory introduction of the DRG reimbursement system forin-patienttherapyinGermanyin2004anditsimplications toprovidecareatnon-revenue-exceedingcostsforcesphysicianstoincreasetheircostawarenessandconsecutivelytoan adjustmentofcaretorevenues.Out-patienttreatmentofFN has been advocated over more than a decade [20][21][22][23] and a classification system for different FN risks [24] with risk-adjusted out-patient treatment was developed and evaluated [25,26]. But despite its potential for a better cost-effectiveness [21],untilthepresenttimeout-patienttreatmentofFN inlow-riskgroupsisnottheadoptedstandardofcareinGermany,sofar.Interestingly,thechargesforin-patientFNcan vary dramatically, even among low-risk patient groups, in differentcountries,e.g.betweentheUSAandGermany.For almostidenticallengthsofhospitalstayof5.7versus5.4days for FN treatment, the total mean charges in the USA were withinalow-riskgroupofn=126in-patients$13,614-16,849 compared to only € 2144.82 (€ 1266-2660) in this study of n=11patients,adifferenceofabout6-12-fold [19].Thenonexisting profit margins in the German DRGs explain why Germanhospitalsareexplicitlyandincreasinglyaggressively comparing their own costs and revenues, to consequently adjusttheirmedicalcaretotherevenues.Asanexample,itis evidentfromtheDRGrevenuesforchemo-inducedFNthat, duetoitscosts,Neupogen [9,27].…”

Review: SABCS 2010 – Aktuelle Therapie der Patientin mit einem Mammakarzinom

“…Eine interessante Arbeit wurde jedoch zu den Taxanen in der metastasierten Situation präsentiert [52]. …”