Management of Febrile Neutropenia - a German Prospective Hospital Cost Analysis in Lymphoproliferative Disorders, Non-Small Cell Lung Cancer, and Primary Breast Cancer

Background: Febrile neutropenia/leukopenia (FN/FL) is the most frequent dose-limiting toxicity of myelosuppressive chemotherapy, but German data on economic consequences are limited. Patients and Methods: A prospective, multicentre, longitudinal, observational study was carried out to evaluate the occurrence of FN/FL and its impact on health resource utilization and costs in non-small cell lung cancer (NSCLC), lymphoproliferative disorder (LPD), and primary breast cancer (PBC) patients. Costs are presented from a hospital perspective. Results: A total of 325 consecutive patients (47% LPD, 37% NSCLC, 16% PBC; 46% women; 38% age >= 65 years) with 68 FN/FL episodes were evaluated. FN/FL occurred in 22% of the LPD patients, 8% of the NSCLC patients, and 27% of the PBC patients. 55 FN/FL episodes were associated with at least 1 hospital stay (LPD n = 34, NSCLC n = 10, PBC n = 11). Mean (median) cost per FN/FL episode requiring hospital care amounted to (sic) 3,950 ((sic) 2,355) and varied between (sic) 4,808 ((sic) 3,056) for LPD, (sic) 3,627 ((sic) 2,255) for NSCLC, and (sic) 1,827 ((sic) 1,969) for PBC patients. 12 FN/FL episodes (LPD n = 9, NSCLC n = 3) accounted for 60% of the total expenses. Main cost drivers were hospitalization and drugs (60 and 19% of the total costs). Conclusions: FN/FL treatment has economic relevance for hospitals. Costs vary between tumour types, being significantly higher for LPD compared to PBC patients. The impact of clinical characteristics on asymmetrically distributed costs needs further evaluation

Resource consumption in haemophilia care \u2013 the ESCHQoL study (European study of clinical, health economic and quality of life outcomes in haemophilia treatment)

Background: Determination of resource consumption is the basic information for health economic analyses. In this study resource consumption associated with haemophilia was measured and quantified. Methods and Patients: ESCHQoL was designed as a retrospective/prospective multicentre, multinational cohort study. Patients (pts) were consecutively enrolled. This analysis focused on data from patient diaries. Results: One thousand and seventy-three diaries were analyzed (752adults: 35.6 \ub1 14.2 years; 321 children: 10.6 \ub1 3.5). 549 adults, 213 children with severe haemophilia. 55% pts had in 6 months on average eight Comprehensive Care Center visits, 30% pts consulted 5-times their GP. In 6 months 17% pts were hospitalised (8.0 days on average). 19% pts had physiotherapy, on average 15-times in 6 months. 344 pts had 15 days, 27% care givers on average 14 days lost of productivity in 6 months. Mean factor consumption for adults varied from approx. 400 IU per kg/year up to 4000 IU per kg/year. Children: mean values ranged from 500 IU per kg/year up to 6600 IU per kg/year. Conclusion: ESCHQoL showed that high resource consumption is associated with haemophilia. Factor use varies between European countries. These results are the basis for future cost analyses and discussions on resource allocatio