Evaluating the total costs of chemotherapy-induced febrile neutropenia: Results from a pilot study with community oncology cancer patients

Charles L. Bennett, Elizabeth A. Calhoun

Research output: Contribution to journalArticle

52 Scopus citations

Abstract

Purpose. While cancer chemotherapy-related febrile neutropenia affects patients' activities and medical expenditures, few studies have reported on the total costs of this condition. Here, we evaluate the feasibility of obtaining detailed and comprehensive cost information on patients who experience febrile neutropenia during cancer chemotherapy treatment. Methods. Community oncology cancer patients who experienced chemotherapy-associated febrile neutropenia recorded information about use of medical care, tests, devices, medications, and lost productivity. Direct cost estimates were derived from Medicare Physician Fee Schedules and cost-to-charge ratios. Indirect cost estimates were based on modified Labor Force, Employment, and Earnings data for employed patients and wages earned by paid caregivers. Multivariate regression models evaluated predictors of higher direct, indirect, and total costs. Results. Outpatients' mean direct and indirect costs were $5,704 and $1,201 (lymphoma), $1,094 and $1,530 (breast cancer), and $1,329 and $1,325 (lung cancer and myeloma), respectively. The mean direct and indirect costs were three- to tenfold and 1.5- to threefold greater for inpatients, respectively. Factors associated with higher direct costs of care included diagnosis of lymphoma and inpatient care; higher indirect costs, male versus female gender; higher total costs, lymphoma diagnosis and inpatient care. Conclusion. Estimation of the total costs of cancer-related neutropenia is feasible. Indirect costs appear to account for as much as half of the total supportive care costs when febrile neutropenia is managed in the outpatient setting and about one fifth of the total supportive care costs in the inpatient setting.

Original languageEnglish (US)
Pages (from-to)478-483
Number of pages6
JournalOncologist
Volume12
Issue number4
DOIs
StatePublished - May 10 2007
Externally publishedYes

Keywords

  • Chemotherapy
  • Costs
  • Febrile neutropenia
  • Toxicity

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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