Evaluation of hospitalization costs for treatment of febrile neutropenia (FN)

Abstract

17549 Background: FNis a common, serious adverse effect of chemotherapy; treatment is costly as it typically involves hospitalisation, use of intravenous antibiotics, and occasionally hematopoietic growth factors (CSFs). Several studies have evaluated direct medical costs of hospitalisation for FN; no Canadian studies detailing the costs associated with modern treatment protocols are available. Methods: A consecutive sample of patients admitted to an inpatient hematology/oncology ward at a tertiary care hospital (Sunnybrook Health Sciences Centre in Toronto, Canada) was enrolled in this study. The inclusion criteria were: 1) diagnosis of chemotherapy-induced FN upon admission and 2) ≥ 18 years of age at time of admission. Patients were followed prospectively during hospitalization and information on medical resource utilization, including length of stay, medications, laboratory and diagnostic tests, was collected. Costs, extracted from hospital and provincial databases, were used to calculate the overall cost, in 2007 Canadian dollars (CAD), per FN episode, from the hospital perspective. Results: Fifty-one episodes of FN occurred in 46 patients; 75% of episodes were classified as low risk based the Multinational Association of Supportive Care in Cancer (MASCC) risk score model. Fifty-one percent of episodes occurred in females and 65% of episodes occurred in patients with hematologic malignancies. Mean ± SD age of patients was 60.3 ± 13.4 years. CSFs were used in 29% of the episodes. The mean length of stay per episode was 6.8 ± 4.9 days. The mean costs of antibiotics and CSFs were 258 ± 413CAD and 354 ± 721CAD, respectively. The mean overall cost per episode was 5800 ± 4275CAD. Conclusions: Hospitalization for the treatment of FN is expensive. Future work will evaluate cost-effectiveness of alternative treatment models for FN, such as outpatient treatment or early hospital discharge programs for low risk episodes, and prophylactic interventions such as the use of CSFs. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration Amgen Canada Amgen Canada