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Pharmacy World and Science

, Volume 16, Issue 4, pp 187–192 | Cite as

Economic study of neutropenia induced by myelotoxic chemotherapy

  • M. C. Montero
  • M. L. Valdivia
  • E. Carvajal
  • A. Montaño
  • C. Buenestado
  • A. Lluch
  • M. Atienza
Articles

Abstract

This article describes the economic and social impact of nutropenia induced by myelotoxic chemotherapy in patients with cancer during the period 1 January–31 December 1991. Neutropenia is a life-threatening complication of chemotherapy in patients with cancer. The episodes of (ever and infections originating from neutropenia require hospitalization of the patient until the granulocyte levels are restored. The calculation of the economic cost was based on the following parameters: length of stay in hospital, analytical tests performed on the patient, type and cost of drug therapy administered, blood transfusions performed, health assistance received, cost of isolation and absence from work. The overall economic cost of neutropenia in patients with cancer reached 329,775 pesetas ($2,893). Cost of the health-care staff was the largest budget item in relation to the total health resources estimated.

Keywords

Antineoplastic agents Cost and cost analysis Diagnostic lests Drug therapy Health manpower Neutropenia Radiotherapy 

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References

  1. 1.
    Muggia FM, Carter SK. Malignant diseases. In: Speight TM, editor. Avery's drug treatment: principles and practice of pharmacology and therapeutics. 3rd ed. Auckland: Adis Press, 1987:1023–77.Google Scholar
  2. 2.
    Bodey GP. Infection in cancer patients: a continuing association. Am J Med 1986;81 Suppl 1A:11–26.Google Scholar
  3. 3.
    Murray N. The importance of dose and dose intensity in lung cancer chemotherapy. Sem Oncol 1987;14 Suppl 4:20–8.Google Scholar
  4. 4.
    Gucalp R. Management of the febrile neutropenic patient with cancer. Oncology 1991;5(7):137–44.PubMedGoogle Scholar
  5. 5.
    O'Hanley P, Easaw J, Rugo H, Easaw S. Infections management of adult leukemic patients undergoing chemotherapy: 1982 to 1986 experience at Stanford University Hospital. Am J Med 1989;87:605–13.PubMedGoogle Scholar
  6. 6.
    Crane VS. Pharmacoeconomics: therapeutic and economic considerations in treating the critically ill patient. DICP. Ann Pharmacother 1990;24(11 Suppl):S24–7.Google Scholar
  7. 7.
    Bronchud MH, Scarffe JH, Thacher N, Crowther D, Souza LM, Alton NK, et al. Phase I/II study of recombinant human granulocyte colony-stimulating factor in patients receiving intensive chemotherapy for small cell lung cancer. Br J Cancer 1987;56:809–13.PubMedGoogle Scholar
  8. 8.
    Pizzo PA, Meyers J. Infections in the cancer patient. In: DeVita VT, Hellmann S, Rosenberg SA, editors. Cancer: principles and practice of oncology. 3rd ed. Philadelphia: Lippincott, 1989:2088–133.Google Scholar
  9. 9.
    Sculier JP, Weets D, Klastersky J. Causes of death in febrile granulocytopenia cancer patients receiving empiric antibiotic therapy. Eur J Cancer Clin Oncol 1984;20:55–60.PubMedGoogle Scholar
  10. 10.
    Mayer KH, De Torres OH. Current guidelines on the use of bacterial drugs in patients with malignancies. Drugs 1985;25:273–9.Google Scholar
  11. 11.
    Faulds D, Lewis NJW, Milne RJ. Recombinant granulocyte colony-stimulating factor (rC-CSF). Pharmacoeconomic considerations in chemotherapy-induced neutropenia. PharmacoEconomics 1992;1(4):231–49.PubMedGoogle Scholar
  12. 12.
    Baremo oficial de Honorarios profesionales del Area del Laboratorio en unidades. [Official criterion of professional fees of laboratory area in units]. Madrid: Asociación Española de Biopatología Clínica, 1991.Google Scholar
  13. 13.
    Carroll NV, Erwin WG. Effect of the prospective-pricing system on drug use in Pennsylvania long-term-care facilities. Am J Hosp Pharm 1990;47(10):2251–4.PubMedGoogle Scholar
  14. 14.
    Sagmeister M, Horisberger B, Gessner U, Berger D. Assessment of the costs of side effects in cancer chemotherapy: method and result of a multinational study. Fifth International Conference on System Science. In: Chytil MK, Duru G, Eimeren W, Flage Ch, editors. Health care. Prague: Omnipress Publishing, 1992:758–61.Google Scholar
  15. 15.
    Pekurinen M, Rissanen P. Economic aspects of treating febrile neutropenic event: the Finnish case study. Kuopio: University of Kuopio, 1991.Google Scholar
  16. 16.
    Antonanzas F, Rovira J, Garruz R, Anton F. Economic evaluation of prophylaxis with the recombinant stimulating factor of granulopoiesis. Med Clin (Barc) 1992;99:685–9.Google Scholar
  17. 17.
    Linstone HA, Turoff M, editors. The Delphi method: techniques and applications. Boston: Adison-Wesley, 1975.Google Scholar
  18. 18.
    Martino P, Girmenia C, Raccah R, Micozzi A, Cimino G, Sgadari C, et al. Single daily dose ceftriaxone plus amikacin treatment of febrile episodes in neutropenic patients attending day hospital for hematologic malignancies. Oncology 1992;49(1):49–52.PubMedGoogle Scholar
  19. 19.
    Calandra T, Cometta A. Antibiotic therapy for gram-negative bacteremia. Infect Dis Clin North Am 1991;5(4):817–34.PubMedGoogle Scholar
  20. 20.
    Viscoli C, Moroni C, Boni L, Bruzzi P, Comelli A, Dini G et al. Ceftazidime plus amikacin versus ceftazidime plus vancomycin as empiric therapy in febrile neutropenic children with cancer. Rev Infect Dis 1991;13(3):397–404.PubMedGoogle Scholar
  21. 21.
    Brumfit W, Hamilton-Miller JMT. Principles and practice of antimicrobial chemotherapy. In: Speight TM, editor. Avery's drug treatment: principles and practice of clinical pharmacology and therapeutics. 3rd ed. Auckland: Adis Press, 1987:1207–35.Google Scholar
  22. 22.
    Schimpff SC. Overview of empiric antibiotic therapy for the febrile neutropenic patient. Rev Infect Dis 1985;7 Suppl. 4:S734–40.PubMedGoogle Scholar
  23. 23.
    Bronchud MH, Howell A, Crowther D, Hopwood P, Souza L, Dexter TM. The use of granulocyte colony-stimulating factor to increase the intensity of treatment with doxorubicin in patients with advanced breast and ovarian cancer. Br J Cancer 1989;60:121–5.PubMedGoogle Scholar
  24. 24.
    Lieschke CJ, Burgess AW. Granulocyte colony-stimulating factor and granulocyte-macrophage colony-stimulating factor. N Engl J Med 1992;327:28–35.PubMedGoogle Scholar
  25. 25.
    Blackwell S, Crawford J. Colony-stimulating factors: clinical applications. Pharmacotherapy 1992;12(2):20S-31S.PubMedGoogle Scholar
  26. 26.
    Crawford J, Ozer H, Stoller R, Johnson D, Lyman G, Tabbara I, et al. Reduction by granulocyte colony-stimulating factor of fever and neutropenia induced by chemotherapy in patients with small cell lung cancer. N Engl J Med 1991;325:164–70.PubMedGoogle Scholar
  27. 27.
    Gulati SC, Bennett CL. Granulocyte-macrophage colony-stimulating factor (GM-CSF) as adjunct therapy in relapsed Hodgkin Disease. Ann Intern Med 1992;116:177–82.PubMedGoogle Scholar

Copyright information

© Royal Dutch Association for Advancement of Pharmacy 1994

Authors and Affiliations

  • M. C. Montero
    • 1
  • M. L. Valdivia
    • 1
  • E. Carvajal
    • 1
  • A. Montaño
    • 1
  • C. Buenestado
    • 1
  • A. Lluch
    • 1
  • M. Atienza
    • 1
  1. 1.Servicio de FarmaciaHospital Universilario “Virgen del Rocío”3-SevillaSpain

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