Cost of chemotherapy‐induced thrombocytopenia among patients with lymphoma or solid tumors

Abstract

BACKGROUNDThe purpose of this study was to estimate the mean incremental cost of chemotherapy‐induced thrombocytopenia and the drivers of cost. Another goal was to estimate the impact of depth and duration of thrombocytopenia on the cost of thrombocytopenia.METHODSA retrospective cohort, consisting of a random sample of 75 solid tumor or lymphoma patients who developed chemotherapy‐induced thrombocytopenia (≤ 50,000 platelets per μl), was chosen. The number of each type of resource used during 217 cycles with and 300 cycles without thrombocytopenia were multiplied by the cost of each resource and summed to yield the total cost of care (in 1999 dollars from the provider's perspective).RESULTSCompared with cycles without thrombocytopenia, the mean incremental cost of thrombocytopenia was $1037 per cycle. However, 60% of cycles were usual cost, with a mean cost of thrombocytopenia of $43 per cycle less than control cycles. Twelve percent of cycles were high cost (mean incremental cost = $612 per cycle); 28% were very high cost (mean incremental cost = $3519). The excess cost during high‐cost cycles was due to high consumption of prophylactic platelet transfusions and during very high‐cost cycles to both higher platelet transfusion consumption and to a high incidence of major bleeding episodes.CONCLUSIONSAlthough thrombocytopenia is a common complication of chemotherapy, only 40% of cycles with thrombocytopenia would be considered high or very high cost. Interventions targeted at this subset of cycles could significantly reduce the cost of thrombocytopenia provided they are initiated early enough in the chemotherapy experience to be effective. Cancer 2003;97:1541–50. © 2003 American Cancer Society.DOI 10.1002/cncr.11195

Supportive and Palliative Care in Solid Cancer Patients

“…Later in 1878 and 1984 this was reported happening among patient suffering from solid cancer [72]. Thrombocytopenia as a serious side effect is usually associated with solid cancer as a result of its metastasis to bone marrow.…”

Early economic evaluation ot technologies for emerging interventions to personalize breast cancer treatment

“…Yet it has to be proven, first, whether the ease of assaying outweighs the uncertainty on which lesion is being investigated, and second, whether the bloodstream ("liquid biopsies") can be used sufficiently reliable to forego tumor sampling [56,57]. Focusing outside of the tumor, host factors can affect the sensitivity of these, as they contribute significantly to varying drug responses.…”

“…This paper contributes to the literature on real-time applications of EVSI analysis to design and prioritize further research, which is under-represented [54][55][56][57][58]. Groot Koerkamp et al [55] 4 previously presented an EVSI application in a diagnostic procedure, but most EVSI analyses are applied to treatment interventions.…”

“…When this information was not available or unclear, we made use of literature [53] where the most frequent quantity of MRIs per type of hospital is presented (three for academic hospitals and one for general hospitals). for a breast radiologist to interpret one MRI scan [57]. The workable hours a year of a breast radiologist were calculated exactly as explained in footnote 2.…”

“…Canada [48] due to the lack of a Dutch estimator, NHS reference costs [27,41,[49][50][51][52][53][54][55][56] and average selling prices from CMS [28] and literature [57][58][59][60][61][62][63] for the US. All costs were inflated to 2013 values using the Consumer Price Index [64] and transformed to Euros [65].…”