Retrospective cost analysis of management of febrile neutropenia in cancer patients in Spain

Mayordomo, J. I.; López, Andrés; Viñolas, Núria; Castellanos, Jorge; Pernas, Sònia; Alonso, J.; Frau, A.; Layola, M.; Gasquet, J. A.; Sánchez, J.

doi:10.1185/03007990903209563

Cited by 45 publications

(56 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The FN occurrence rate of patients in cycle 1 was 21.0% (22/105). In agreement with a report by Mayordomo et al (17), 53.7% of all FN events (22/41) occurred during cycle 1. Lyman et al (18) reported that a lack of primary prophylaxis with G-CSF in cycle 1 was associated with an increased risk of FN (18).…”

Section: Resultssupporting

confidence: 82%

Chemotherapy continuity and incidence of febrile neutropenia with CHOP therapy in an outpatient setting

Usami

Kimura

Iwai

et al. 2016

Molecular and Clinical Oncology

View full text Add to dashboard Cite

Abstract. The cyclophosphamide, doxorubicin, vincristine and prednisolone (CHOP) regimen is considered to be a standard treatment for non-Hodgkin's lymphoma (NHL). Patients receiving CHOP chemotherapy often experience febrile neutropenia (FN) due to myelotoxicity. The proper management of FN is essential to guarantee a positive outcome of the NHL treatment. Therefore, the present study retrospectively examined chemotherapy continuity and the incidence of FN during CHOP therapy in an outpatient setting. The subjects were 136 patients who received CHOP chemotherapy between January 2012 and December 2014. A total of 31 patients unable to be treated in an outpatient setting were excluded from the study. Of the remaining 105 patients, 73 patients who did not require hospitalization during the chemotherapy treatment were included in the non-hospitalized group, and 32 patients who required hospitalization during chemotherapy treatment were included in the re-hospitalization group. The numbers of patients from these two groups who completed the planned treatment were 71 and 24, respectively (P<0.01). In addition, the duration of granulocyte-colony stimulating factor (G-CSF) treatment was 5.3±1.22 and 6.1±1.46 days, respectively (P<0.01). The numbers of patients experiencing FN in an outpatient setting were 14 and 19, respectively (P<0.01). During administration of primary prophylaxis with G-CSF, the incidence of FN was 21.0% (22/105) in cycle 1. In conclusion, the present study has revealed a requirement to educate patients about infection prevention prior to the first cycle of chemotherapy. Patients who require the administration of long-term G-CSF are at risk of unplanned re-hospitalization, and treating them with polyethylene glycol G-CSF to reduce the number of required injections should be considered as an option. Therefore, proper supportive therapy and management of infection are important to safely treat patients with CHOP in an outpatient setting.

show abstract

Section: Resultssupporting

confidence: 82%

Chemotherapy continuity and incidence of febrile neutropenia with CHOP therapy in an outpatient setting

Usami

Kimura

Iwai

et al. 2016

Molecular and Clinical Oncology

View full text Add to dashboard Cite

show abstract

“…The bulk of economic literature on supportive care strategies comes from the United States [9,10], where costs of a health care intervention usually range substantially higher than in Europe [11,29,30]. In contrast, variations between European cost estimates seem to be much lower.…”

Section: Cost Of Toxicity Managementmentioning

confidence: 99%

“…For European health care systems and especially for Germany, microeconomic data on supportive care interventions are scarce [11,12]. The existing health economic literature, mainly studies from the United States, focuses on particular toxic effects such as anaemia [11,13], febrile neutropenia (FN) [7,14,15], thrombocytopenia and bleeding [16,17], mucositis [18] and CT-induced nausea and vomiting [2].…”

mentioning

confidence: 99%

Health resource consumption and costs attributable to chemotherapy-induced toxicity in German routine hospital care in lymphoproliferative disorder and NSCLC patients

Paessens¹,

Schilling

Berger

et al. 2011

Annals of Oncology

View full text Add to dashboard Cite

Background: Multidrug chemotherapy (CT) is still associated with relevant side-effects. We assessed, under current practice patterns, frequency and severity of CT-induced toxicity and its economic consequences.Patients and methods: Prospective, multicentre, longitudinal, observational cohort study with lymphoproliferative disorder (LPD) and non-small-cell lung cancer (NSCLC) patients, receiving first-or second-line (immuno-) CT (excluding myeloablative CT). Data were collected from patient interviews and preplanned chart reviews. Costs in 2007 euros are presented from the provider perspective.Results: Two hundred and seventy-three patients (n = 153 LPD; n = 120 NSCLC) undergoing a total of 1004 CT cycles were assessable (age ‡65 years, 40%; female, 36%; Eastern Cooperative Oncology Group performance status ‡2, 11%; tumour stage ‡III, 56%; history of comorbidity, 80%). Fifty percent of cycles were associated with grade 3/4 toxicity and 37% (n = 371) with at least one hospital stay (outpatient/day care n = 154; intensive care n = 19). Mean (median) toxicity-related costs amounted to €1032 (€86) per cycle. Costs rose exponentially with the number of grade 3/4 adverse drug reactions (ADRs) and were highest in cycles affected by more than four ADRs, €10 881 (€5455); in cycles with intensive care, €14 121 (€8833); and in cycles affected by grade 3/4 infections and febrile neutropenia/ leukopenia, €7093 (€4531) and €5170 (€2899), respectively. Five percent of CT cycles accounted for 56% of total expenses.Conclusions: Individualised supportive care strategies are needed. Future research should focus on identifying toxicity clusters and patient characteristics predictive for high costs.

show abstract

“…One of the main drivers of costs related to antineoplastic chemotherapy is hospitalization which often includes other direct and indirect medical costs such as antibacterial treatment and inability to work [11,12]. …”

Section: Introductionmentioning

confidence: 99%

NADIR: A Non-Interventional Study on the Prophylaxis of Chemotherapy-Induced Neutropenia Using Lipegfilgrastim - First Interim Analysis

Kurbacher¹,

Fietz²,

Diel³

et al. 2015

Oncol Res Treat

View full text Add to dashboard Cite

Background: The non-interventional study (NIS) NADIR was designed to assess the effectiveness and safety of lipegfilgrastim, a novel glycopegylated granulocyte-colony stimulating factor, in reducing the risk of both febrile and severe neutropenia. Methods: Here, the interim analysis of NIS Nadir performed under real-world conditions at 80 oncology practices across Germany is reported. For a patient to be included, lipegfilgrastim at a subcutaneous single dose of 6 mg had to be administered during at least 1 cycle of the chemotherapy under consideration. Results: The interim analysis included 224 patients. Median patient age was 61.1 years (interquartile range 51.2-70.2 years). Main tumor type was breast cancer followed by lung cancer, and non-Hodgkin's lymphoma (46.0, 13.4, and 10.7%, respectively). When lipegfilgrastim was given as primary prophylaxis, no patient developed febrile neutropenia (FN). 1.3% of patients developed FN when primary prophylaxis was withheld. Only 68.6% of patients undergoing chemotherapy and at high risk (> 20%) of developing FN were treated with lipegfilgrastim during the first cycle, exposing disparity between real-world practices and current treatment guidelines. Lipegfilgrastim was well tolerated. The only grade 3/4 treatment-related adverse event was anemia in 1 patient. Conclusion: Lipegfilgrastim was effective and safe when administered for the prevention of chemotherapy-induced neutropenia under real-world conditions.

show abstract

Retrospective cost analysis of management of febrile neutropenia in cancer patients in Spain

Abstract: 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.

Cited by 45 publications

References 6 publications

Chemotherapy continuity and incidence of febrile neutropenia with CHOP therapy in an outpatient setting

Chemotherapy continuity and incidence of febrile neutropenia with CHOP therapy in an outpatient setting

Health resource consumption and costs attributable to chemotherapy-induced toxicity in German routine hospital care in lymphoproliferative disorder and NSCLC patients

NADIR: A Non-Interventional Study on the Prophylaxis of Chemotherapy-Induced Neutropenia Using Lipegfilgrastim - First Interim Analysis

Contact Info

Product

Resources

About