Cost of chemotherapy-induced thrombocytopenia among patients with lymphoma or solid tumors
Cost of chemotherapy-induced thrombocytopenia among patients with lymphoma or solid tumors
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DOI：
10.1002/cncr.11195
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发表时间：
2003-03-15
期刊：
影响因子：
6.2
通讯作者：
Benjamin, RS
中科院分区：
文献类型：
--
作者：
Elting, LS;Cantor, SB;Benjamin, RS
背景资料。这项研究的目的是估计化疗引起的血小板减少症的平均增量成本和成本的驱动因素。另一个目标是评估血小板减少的深度和持续时间对治疗费用的影响。方法：随机抽取75例实体瘤或淋巴瘤患者为研究对象，随机抽取75例出现化疗所致的血小板减少(小于或等于50,000个/微米)的实体瘤或淋巴瘤患者为研究对象，进行回顾性队列研究。在有血小板减少的217个周期和没有血小板减少的300个周期中使用的每种资源的数量乘以每个资源的成本，并相加得到总的护理成本(从提供者的角度来看，以1999美元计算)。结果：与没有血小板减少的周期相比，每个周期血小板减少的平均增量成本为1037美元。然而，60%的周期是常规费用，平均每个周期的血小板减少费用比对照周期少43美元。12%的周期成本较高(平均增量成本=每周期612美元)；28%的周期成本非常高(平均增量成本=3519美元)。在高费用周期中的额外费用是由于预防性血小板输注的高消耗，以及在非常高的费用周期中由于更高的血小板输注消耗和大出血事件的高发生率。结论：尽管血小板减少是化疗的常见并发症，但只有40%的血小板减少的周期被认为是高或非常高的费用。针对这一周期子集的干预措施可以显著降低血小板减少症的成本，前提是在化疗经验中足够早地开始干预，使其有效。(C)2003年美国癌症协会。
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 (less than or equal to50,000 platelets per mul), 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. (C) 2003 American Cancer Society.