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

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, consisti...

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Veröffentlicht in:Cancer 2003-03, Vol.97 (6), p.1541-1550
Hauptverfasser: Elting, Linda S., Cantor, Scott B., Martin, Charles G., Hamblin, Lois, Kurtin, Danna, Rivera, Edgardo, Vadhan‐Raj, Saroj, Benjamin, Robert S.
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container_end_page 1550
container_issue 6
container_start_page 1541
container_title Cancer
container_volume 97
creator Elting, Linda S.
Cantor, Scott B.
Martin, Charles G.
Hamblin, Lois
Kurtin, Danna
Rivera, Edgardo
Vadhan‐Raj, Saroj
Benjamin, Robert S.
description 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 Thrombocytopenia is a common complication of chemotherapy among patients with solid tumors, but it contributes significantly to the total cost of care in only 40% of cycles in this population. Targeting interventions at high‐cost cycles may have significant financial impact.
doi_str_mv 10.1002/cncr.11195
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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 Thrombocytopenia is a common complication of chemotherapy among patients with solid tumors, but it contributes significantly to the total cost of care in only 40% of cycles in this population. Targeting interventions at high‐cost cycles may have significant financial impact.</description><identifier>ISSN: 0008-543X</identifier><identifier>EISSN: 1097-0142</identifier><identifier>DOI: 10.1002/cncr.11195</identifier><identifier>PMID: 12627519</identifier><identifier>CODEN: CANCAR</identifier><language>eng</language><publisher>New York: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Antineoplastic Combined Chemotherapy Protocols - adverse effects ; Biological and medical sciences ; Cohort Studies ; complications of chemotherapy ; cost of care ; Cost of Illness ; Drug toxicity and drugs side effects treatment ; Female ; Health Care Costs - statistics &amp; numerical data ; Humans ; incremental costs ; Lymphoma - drug therapy ; Male ; Medical sciences ; Middle Aged ; Neoplasms - drug therapy ; Pharmacology. Drug treatments ; Platelet Transfusion ; platelet transfusions ; Retrospective Studies ; thrombocytopenia ; Thrombocytopenia - chemically induced ; Thrombocytopenia - economics ; Toxicity: blood</subject><ispartof>Cancer, 2003-03, Vol.97 (6), p.1541-1550</ispartof><rights>Copyright © 2003 American Cancer Society</rights><rights>2003 INIST-CNRS</rights><rights>Copyright 2003 American Cancer Society.DOI 10.1002/cncr.11195</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3555-731aa7595e8537125b5e0b6cc057259174f27a2a7dd489ba3fca92abb69f5c163</citedby><cites>FETCH-LOGICAL-c3555-731aa7595e8537125b5e0b6cc057259174f27a2a7dd489ba3fca92abb69f5c163</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fcncr.11195$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fcncr.11195$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,782,786,1419,1435,27931,27932,45581,45582,46416,46840</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=14656060$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12627519$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Elting, Linda S.</creatorcontrib><creatorcontrib>Cantor, Scott B.</creatorcontrib><creatorcontrib>Martin, Charles G.</creatorcontrib><creatorcontrib>Hamblin, Lois</creatorcontrib><creatorcontrib>Kurtin, Danna</creatorcontrib><creatorcontrib>Rivera, Edgardo</creatorcontrib><creatorcontrib>Vadhan‐Raj, Saroj</creatorcontrib><creatorcontrib>Benjamin, Robert S.</creatorcontrib><title>Cost of chemotherapy‐induced thrombocytopenia among patients with lymphoma or solid tumors</title><title>Cancer</title><addtitle>Cancer</addtitle><description>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 Thrombocytopenia is a common complication of chemotherapy among patients with solid tumors, but it contributes significantly to the total cost of care in only 40% of cycles in this population. Targeting interventions at high‐cost cycles may have significant financial impact.</description><subject>Antineoplastic Combined Chemotherapy Protocols - adverse effects</subject><subject>Biological and medical sciences</subject><subject>Cohort Studies</subject><subject>complications of chemotherapy</subject><subject>cost of care</subject><subject>Cost of Illness</subject><subject>Drug toxicity and drugs side effects treatment</subject><subject>Female</subject><subject>Health Care Costs - statistics &amp; numerical data</subject><subject>Humans</subject><subject>incremental costs</subject><subject>Lymphoma - drug therapy</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neoplasms - drug therapy</subject><subject>Pharmacology. Drug treatments</subject><subject>Platelet Transfusion</subject><subject>platelet transfusions</subject><subject>Retrospective Studies</subject><subject>thrombocytopenia</subject><subject>Thrombocytopenia - chemically induced</subject><subject>Thrombocytopenia - economics</subject><subject>Toxicity: blood</subject><issn>0008-543X</issn><issn>1097-0142</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90MtKxDAUBuAgio6jGx9AsnEjdEzSppkspXiDQUEUXAjlNE1tpGlK0mHozkfwGX0SO87A7FwdDnznwo_QGSUzSgi7Uq3yM0qp5HtoQokUEaEJ20cTQsg84kn8doSOQ_gcW8F4fIiOKEuZ4FRO0HvmQo9dhVWtretr7aEbfr6-TVsulS5xX3tnC6eG3nW6NYDBuvYDd9Ab3fYBr0xf42awXe0sYOdxcI0Zx5bW-XCCDipogj7d1il6vb15ye6jxdPdQ3a9iFTMOY9ETAEEl1zPeSwo4wXXpEiVInz8V1KRVEwAA1GWyVwWEFcKJIOiSGXFFU3jKbrc7FXeheB1lXfeWPBDTkm-jihfR5T_RTTi8w3uloXV5Y5uMxnBxRZAUNBUHlplws4lKU9JSkZHN25lGj38czLPHrPnzfFfZxCA0A</recordid><startdate>20030315</startdate><enddate>20030315</enddate><creator>Elting, Linda S.</creator><creator>Cantor, Scott B.</creator><creator>Martin, Charles G.</creator><creator>Hamblin, Lois</creator><creator>Kurtin, Danna</creator><creator>Rivera, Edgardo</creator><creator>Vadhan‐Raj, Saroj</creator><creator>Benjamin, Robert S.</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><general>Wiley-Liss</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20030315</creationdate><title>Cost of chemotherapy‐induced thrombocytopenia among patients with lymphoma or solid tumors</title><author>Elting, Linda S. ; Cantor, Scott B. ; Martin, Charles G. ; Hamblin, Lois ; Kurtin, Danna ; Rivera, Edgardo ; Vadhan‐Raj, Saroj ; Benjamin, Robert S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3555-731aa7595e8537125b5e0b6cc057259174f27a2a7dd489ba3fca92abb69f5c163</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Antineoplastic Combined Chemotherapy Protocols - adverse effects</topic><topic>Biological and medical sciences</topic><topic>Cohort Studies</topic><topic>complications of chemotherapy</topic><topic>cost of care</topic><topic>Cost of Illness</topic><topic>Drug toxicity and drugs side effects treatment</topic><topic>Female</topic><topic>Health Care Costs - statistics &amp; numerical data</topic><topic>Humans</topic><topic>incremental costs</topic><topic>Lymphoma - drug therapy</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neoplasms - drug therapy</topic><topic>Pharmacology. Drug treatments</topic><topic>Platelet Transfusion</topic><topic>platelet transfusions</topic><topic>Retrospective Studies</topic><topic>thrombocytopenia</topic><topic>Thrombocytopenia - chemically induced</topic><topic>Thrombocytopenia - economics</topic><topic>Toxicity: blood</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Elting, Linda S.</creatorcontrib><creatorcontrib>Cantor, Scott B.</creatorcontrib><creatorcontrib>Martin, Charles G.</creatorcontrib><creatorcontrib>Hamblin, Lois</creatorcontrib><creatorcontrib>Kurtin, Danna</creatorcontrib><creatorcontrib>Rivera, Edgardo</creatorcontrib><creatorcontrib>Vadhan‐Raj, Saroj</creatorcontrib><creatorcontrib>Benjamin, Robert S.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Elting, Linda S.</au><au>Cantor, Scott B.</au><au>Martin, Charles G.</au><au>Hamblin, Lois</au><au>Kurtin, Danna</au><au>Rivera, Edgardo</au><au>Vadhan‐Raj, Saroj</au><au>Benjamin, Robert S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cost of chemotherapy‐induced thrombocytopenia among patients with lymphoma or solid tumors</atitle><jtitle>Cancer</jtitle><addtitle>Cancer</addtitle><date>2003-03-15</date><risdate>2003</risdate><volume>97</volume><issue>6</issue><spage>1541</spage><epage>1550</epage><pages>1541-1550</pages><issn>0008-543X</issn><eissn>1097-0142</eissn><coden>CANCAR</coden><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 Thrombocytopenia is a common complication of chemotherapy among patients with solid tumors, but it contributes significantly to the total cost of care in only 40% of cycles in this population. Targeting interventions at high‐cost cycles may have significant financial impact.</abstract><cop>New York</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>12627519</pmid><doi>10.1002/cncr.11195</doi><tpages>10</tpages></addata></record>
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source MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Access via Wiley Online Library; Wiley Online Library (Open Access Collection); Alma/SFX Local Collection
subjects Antineoplastic Combined Chemotherapy Protocols - adverse effects
Biological and medical sciences
Cohort Studies
complications of chemotherapy
cost of care
Cost of Illness
Drug toxicity and drugs side effects treatment
Female
Health Care Costs - statistics & numerical data
Humans
incremental costs
Lymphoma - drug therapy
Male
Medical sciences
Middle Aged
Neoplasms - drug therapy
Pharmacology. Drug treatments
Platelet Transfusion
platelet transfusions
Retrospective Studies
thrombocytopenia
Thrombocytopenia - chemically induced
Thrombocytopenia - economics
Toxicity: blood
title Cost of chemotherapy‐induced thrombocytopenia among patients with lymphoma or solid tumors
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