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

医学 化疗 入射(几何) 回顾性队列研究 血小板输注 成本效益 外科 总成本 并发症 队列 血小板 内科学 物理 风险分析(工程) 光学 经济 微观经济学
作者
Linda S. Elting,Scott B. Cantor,Charles G. Martin,Lois Hamblin,Danna Kurtin,Edgardo Rivera,Saroj Vadhan‐Raj,Robert S. Benjamin
出处
期刊:Cancer [Wiley]
卷期号:97 (6): 1541-1550 被引量:52
标识
DOI:10.1002/cncr.11195
摘要

Abstract BACKGROUND The 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. METHODS A 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). RESULTS Compared 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. CONCLUSIONS Although 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
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