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Clinical Drug Investigation

Erschienen in:

01.06.2007 | Review Article

Economic Burden of Haematological Adverse Effects in Cancer Patients

A Systematic Review

verfasst von: S. Y. Liou, Dr J. M. Stephens, K. T. Carpiuc, W. Feng, M. F. Botteman, J. W. Hay

Erschienen in: Clinical Drug Investigation | Ausgabe 6/2007

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Abstract

Objective: Patients receiving cancer treatments commonly experience haematological adverse effects (AEs) related to chemotherapy or molecularly targeted therapies, which may be associated with high healthcare costs. The objective of this review was to summarise the published literature on the economic burden of neutropenia, thrombocytopenia and anaemia as AEs of cancer treatment.

Methods: A systematic search of the medical literature published between 1990 and 2006 was conducted using PubMed/MEDLINE, EMBASE, BIOSIS, related article links and supplemental searches. References selected for inclusion were prospective or retrospective studies specifically designed to examine the burden of illness, direct medical costs, indirect costs and/or cost drivers associated with neutropenia, thrombocytopenia and anaemia in adult cancer patients. All costs are reported as originally published and adjusted to 2006 US dollars.

Results: In the US, the cost of neutropenia ranged from $US1893 (2006 value $US2632) per outpatient episode to $US38 583 ($US49 917) per febrile neutropenia hospitalisation. For countries outside the US, the cost of neutropenia appeared to be lower. The cost of thrombocytopenia ranged from $US1035 ($US1395) to $US5328 ($US7635) per cycle or episode in the US. Costs attributable to anaemia ranged from $US18 418 ($US22 775) to $US69 478 ($US93 454) per year in the US. The costs of AEs for patients with haematological malignancies appeared to be up to 2–3 times higher than those for patients with solid tumours. Economic studies of the cost of haematological AEs specific to new molecularly targeted treatments for haematological malignancy have not been published.

Conclusions: Chemotherapy-related haematological AEs result in a substantial economic burden on patients, payers, caregivers and society in general. Because of their burden, the frequency and severity of these toxicities should be one of the key factors in the selection of optimal treatments for patients with cancer, especially those with haematological malignancies. Future research is needed to assess the economic burden of AEs associated with new molecularly targeted treatments for haematological malignancies.

Caggiano V, Weiss RV, Rickert TS, et al. Incidence, cost, and mortality of neutropenia hospitalization associated with chemotherapy. Cancer 2005 May 1; 103(9): 1916–24PubMedCrossRef

Cosier LE, Calhoun EA, Agboola O, et al. Effects of indirect and additional direct costs on the risk threshold for prophylaxis with colony-stimulating factors in patients at risk for severe neutropenia from cancer chemotherapy. Pharmacotherapy 2004; 24(4): 488–94CrossRef

Cullen M, Steven N, Billingham L, et al. Antibacterial prophylaxis after chemotherapy for solid tumors and lymphomas. N Engl J Med 2005 September 8; 353(10): 988–98PubMedCrossRef

Donohue R. Development and implementation of a risk assessment tool for chemotherapy-induced neutropenia. Oncol Nurs Forum 2006 March; 33(2): 347–52PubMedCrossRef

Du XL, Osborne C, Goodwin JS. Population-based assessment of hospitalizations for toxicity from chemotherapy in older women with breast cancer. J Clin Oncol 2002 Dec 15; 20(24): 4636–42PubMedCrossRef

Hartmann LC, Tschetter LK, Habermann TM, et al. Granulocyte colony-stimulating factor in severe chemotherapy-induced afebrile neutropenia. N Engl J Med 1997 June 19; 336(25): 1776–80PubMedCrossRef

Cantor SB, Elting LS, Hudson Jr DV, et al Pharmacoeconomic analysis of oprelvekin (recombinant human interleukin-11) for secondary prophylaxis of thrombocytopenia in solid tumor patients receiving chemotherapy. Cancer 2003 June 15; 97(12): 3099–106PubMedCrossRef

Aledort LM, Mohandas K. Transfusion requirements in patients with malignancy. Semin Hematol 1996 January; 33(1 Suppl. 1): 6–9PubMed

Demetri GD. Anaemia and its functional consequences in cancer patients: current challenges in management and prospects for improving therapy. Br J Cancer 2001 April; 84Suppl. 1: 31–7PubMedCrossRef

10.

Lyman GH, Berndt ER, Kailich JD, et al. The economic burden of anemia in cancer patients receiving chemotherapy. Value Health 2005 March; 8(2): 149–56PubMedCrossRef

11.

Hassett MJ, O’Malley AJ, Pakes JR, et al. Frequency and cost of chemotherapy-related serious adverse effects in a population sample of women with breast cancer. J Natl Cancer Inst 2006 August 16; 98(16): 1108–17PubMedCrossRef

12.

Bristol Myers Squibb Co. Dasatinib (SPRYCEL) product information. Princeton (NJ)/ Bristol Myers Squibb Co 2006

13.

Cosier LE, Sivasubramaniam V, Agboola O, et al. Effect of outpatient treatment of febrile neutropenia on the risk threshold for the use of CSF in patients with cancer treated with chemotherapy. Value Health 2005 January; 8(1): 47–52CrossRef

14.

Calhoun EA, Chang CH, Welshman EE, et al. Evaluating the total costs of chemotherapy-induced toxicity: results from a pilot study with ovarian cancer patients. Oncologist 2001; 6(5): 441–5PubMedCrossRef

15.

Chrischilles EA, Klepser DG, Brooks JM, et al. Effect of clinical characteristics on neutropenia-related inpatient costs among newly diagnosed non-Hodgkin’s lymphoma cases during first-course chemotherapy. Pharmacotherapy 2005 May; 25(5): 668–75PubMedCrossRef

16.

Kuderer NM, Dale DC, Crawford J, et al. Mortality, morbidity, and cost associated with febrile neutropenia in adult cancer patients. Cancer 2006 May 15; 106(10): 2258–66PubMedCrossRef

17.

Cantor SB, Rubenstein EB, Elting LS, et al. Economic evaluation of management strategies for low risk febrile neutropenic cancer patients [abstract no. 1498]. Proc Am Soc Clin Oncol 1997

18.

Del Prete SA, Ryan SP, Jacobson JS, et al. Safety and costs of treating neutropenic fever in an outpatient setting. Conn Med 1999 December; 63(12): 713–7PubMed

19.

Gandhi SK, Arguelles L, Boyer JG. Economic impact of neutropenia and febrile neutropenia in breast cancer: estimates from two national databases. Pharmacotherapy 2001 June; 21(6): 684–90PubMedCrossRef

20.

Lyman GH, Kuderer N, Greene J, et al. The economics of febrile neutropenia: implications for the use of colony-stimulating factors. Eur J Cancer 1998 Nov; 34(12): 1857–64PubMedCrossRef

21.

Glaspy JA, Bleecker G, Crawford J, et al. The impact of therapy with filgrastim (recombinant granulocyte colony-stimulating factor) on the health care costs associated with cancer chemotherapy. Eur J Cancer 1993; 29ASuppl. 7: S23–30PubMedCrossRef

22.

Glaspy JA, Bleecker GC, Crawford J, et al. Decreased costs in cancer chemotherapy patients using recombinant granulocyte colony stimulating factor. Clin Res 1991; 39(1): 7A

23.

Minisini A, Spazzapan S, Crivellari D, et al. Incidence of febrile neutropenia and neutropenic infections in elderly patients receiving anthracycline-based chemotherapy for breast cancer without primary prophylaxis with colony-stimulating factors. Crit Rev Oncol Hematol 2005 Feb; 53(2): 125–31PubMedCrossRef

24.

Annemans L, Giaccone G, Vergnenegre A. The cost-effectiveness of paclitaxel (Taxol) + cisplatin is similar to that of teniposide + cisplatin in advanced non-small cell lung cancer: a multicountry analysis. Anticancer Drugs 1999 Jul; 10(6): 605–15PubMedCrossRef

25.

Herold M, Hieke K. Costs of toxicity during chemotherapy with CHOP, COP/CVP, and fludarabine. Eur J Health Econ 2002; 3(3): 166–72PubMedCrossRef

26.

Dranitsaris G, Tran TM. Economic analyses of toxicity secondary to anthracycline-based breast cancer chemotherapy. Eur J Cancer 1995; 31A(13-14): 2174–80PubMedCrossRef

27.

Dranitsaris G, Tran TM, McGeer A, et al. Pharmacoeconomic analysis of empirical therapy with ceftazidime alone or combination antibiotics for febrile neutropenia in cancer patients. Pharmacoeconomics 1995; 7(1): 49–62PubMedCrossRef

28.

Korpela J, Salminen E. Neutropenic infections add significant costs to palliative chemotherapy in breast cancer. Anticancer Res 2002; 22(2B): 1337–40PubMed

29.

Garcia-Carbonero R, Mayordomo JI, Tornamira MV, et al. Granulocyte colony-stimulating factor in the treatment of high-risk febrile neutropenia: a multicenter randomized trial. J Natl Cancer Inst 2001; 93(1): 31–8PubMedCrossRef

30.

Mayordomo JI, Rivera F, az-Puente MT, et al. Improving treatment of chemotherapy-induced neutropenic fever by administration of colony-stimulating factors. J Natl Cancer Inst 1995; 87(11): 803–8PubMedCrossRef

31.

Montera MC, Valdivia ML, Carvajal E, et al. Economic study of neutropenia induced by myelotoxic chemotherapy. Pharm World Sci 1994 Aug 5; 16(4): 187–92CrossRef

32.

Hackshaw A, Sweetenham J, Knight A. Are prophylactic haematopoietic growth factors of value in the management of patients with aggressive non-Hodgkin’s lymphoma? Br J Cancer 2004; 90(7): 1302–5PubMedCrossRef

33.

Leese B, Collin R, Clark DJ. The costs of treating febrile neutropenia in patients with malignant blood disorders. Pharmacoeconomics 1994; 6(3): 233–9PubMedCrossRef

34.

Leese B. The costs of treating febrile neutropenia in six U.K. Hospitals. Eur J Cancer 1993; 29ASuppl. 7: S15–8PubMedCrossRef

35.

Elting LS, Cantor SB. Outcomes and costs of febrile neutropenia: adventures in the science and art of treatment choices. Support Care Cancer 2002; 10(3): 189–96PubMedCrossRef

36.

Bennett CL, Stinson TJ, Laver JH, et al. Cost analyses of adjunct colony stimulating factors for acute leukemia: can they improve clinical decision making. Leuk Lymphoma 2000; 37(1-2): 65–70PubMedCrossRef

37.

Elting LS, Cantor SB, Martin CG, et al. Cost of chemotherapy-induced thrombocytopenia among patients with lymphoma or solid tumors. Cancer 2003; 97(6): 1541–50PubMedCrossRef

38.

Malone D, Sullivan S, Black D, et al. The cost of treating chemotherapy-induced thrombocytopenia [abstract no. 887]. Proc Am Soc Clin Oncol 1995

39.

Kaushansky K. Thrombopoietin. N Engl J Med 1998; 339(11): 746–54PubMedCrossRef

40.

Snider C, Erder H, LaBrecque J, et al. What are the true costs of platelet transfusions? A prospective time motion study of resource utilization associated with platelet transfusions at UCLA Medical Center [abstract]. Blood 1996; 88: 333a

41.

Balducci L, Benson K, Lyman GH, et al. Cost-effectiveness of white cell-reduction filters in treatment of adult acute myelogenous leukemia. Transfusion 1993; 33(8): 665–70PubMedCrossRef

42.

Najib MM, Katz LM, Fastenau J, et al. Costs and epidemiology of myelosuppression in chemotherapy-treated metastatic breast cancer patients [abstract no. 2775]. Blood 2003 Nov 16; 102: 11

43.

Berndt E, Crown W, Kallich J, et al. The impact of anaemia and its treatment on employee disability and medical costs. Pharmacoeconomics 2005; 23(2): 183–92PubMedCrossRef

44.

Nissenson AR, Wade S, Goodnough T, et al. Economic burden of anemia in an insured population. J Manag Care Pharm 2005; 11(7): 565–74PubMed

45.

Ershler WB, Chen K, Reyes EB, et al. Economic burden of patients with anemia in selected diseases. Value Health 2005; 8(6): 629–38PubMedCrossRef

46.

Lyman GH, Berndt E, Crown W, et al. Anemia is associated with high cost in newly diagnosed cancer patients [abstract]. Blood 2001 Nov 16; 98 (11 Part 2): 414bCrossRef

47.

Cersosimo RJ, Jacobson DR. Epoetin alfa versus darbepoetin alfa in chemotherapy-related anemia. Ann Pharmacother 2006; 40(1): 58–65PubMed

48.

Cremieux P, Greenberg P, Piech CT. Epoetin alfa is more effective and less costly relative to darbepoetin alfa in lung cancer patients receiving treatment for chemotherapy-induced anemia [abstract no. 2248]. Proc Am Soc Clin Oncol 2003

49.

Sheffield R, Sullivan SD, Saltiel E, et al. Cost comparison of recombinant human erythropoietin and blood transfusion in cancer chemotherapy-induced anemia. Ann Pharmacother 1997; 31(1): 15–22PubMed

50.

Cremieux PY, Finkelstein SN, Berndt ER, et al. Cost effectiveness, quality-adjusted life-years and supportive care. Recombinant human erythropoietin as a treatment of cancer-associated anaemia. Pharmacoeconomics 1999; 16 (5 Pt 1): 459–72PubMedCrossRef

51.

Meadowcroft AM, Gilbert CJ, Maravich-May D, et al. Cost of managing anemia with and without prophylactic epoetin alfa therapy in breast cancer patients receiving combination chemotherapy. Am J Health Syst Pharm 1998; 55(18): 1898–902PubMed

52.

Marchetti M, Barosi G. Clinical and economic impact of epoetins in cancer care. Pharmacoeconomics 2004; 22(16): 1029–45PubMedCrossRef

53.

Kruep EJ, Basskin LE. Cost-minimization analysis of darbepoetin alfa versus epoetin alfa in the hospital setting. Am J Health Syst Pharm 2005; 62(24): 2597–603PubMedCrossRef

54.

Cremieux PY, Barrett B, Anderson K, et al. Cost of outpatient blood transfusion in cancer patients. J Clin Oncol 2000; 18(14): 2755–61PubMed

55.

Cantor SB, Hudson Jr DV, Lichtiger B, et al. Costs of blood transfusion: a process-flow analysis. J Clin Oncol 1998; 16(7): 2364–70PubMed

56.

Mohandas K, Aledort L. Transfusion requirements, risks, and costs for patients with malignancy. Transfusion 1995 May; 35(5): 427–30PubMedCrossRef

57.

Forbes JM, Anderson MD, Anderson GF, et al. Blood transfusion costs: a multicenter study. Transfusion 1991 May; 31(4): 318–23PubMedCrossRef

Titel: Economic Burden of Haematological Adverse Effects in Cancer Patients
A Systematic Review
verfasst von: S. Y. Liou
Dr J. M. Stephens
K. T. Carpiuc
W. Feng
M. F. Botteman
J. W. Hay
Publikationsdatum: 01.06.2007
Verlag: Springer International Publishing
Erschienen in: Clinical Drug Investigation / Ausgabe 6/2007
Print ISSN: 1173-2563
Elektronische ISSN: 1179-1918
DOI: https://doi.org/10.2165/00044011-200727060-00002

Springer Medizin

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