Abstract
Background
Febrile Neutropenia (FN), a commonly encountered life-threatening complication of cancer chemotherapy, is a dose-limiting toxicity in the therapy of many cancers. The onset of FN demands dose reduction and usually temporary halting of chemotherapy, which could then affect the outcome of cancer treatment. The treatment of febrile neutropenia incurs significant expenses,and is itself regarded as an expensive side-effect of cancer chemotherapy. In our study, we wanted to quantify the drugs used in the treatment of febrile neutropenic episodes and the costs incurred as a result, as well as the outcomes of these episodes.
Methods
The study was a prospective observational study. Patients of either sex, of any age, diagnosed with cancer and classified as high-risk febrile neutropenia and hospitalised during the period of study were included in the study. A total of 46 patients with 50 episodes of FN were enrolled in the study. Data was collected from the department database and daily clinical notes and was entered into a pre-designed proforma. The drugs prescribed were classified as antibiotics and supportive medications. The drug cost of each episode was then calculated. The data was analysed using descriptive statistics.
Results
The mean age of participants was 26.66 (SD 13.28) years, with a median length of hospital stay of 10 (7–15) days. This study provides an estimate into the drug-related costs of management of febrile neutropenia. A total of Rs. 8,21,731 was spent on drugs for the management of fifty episodes, and the average cost of an episode was Rs. 16,434. Of the total cost, Rs. 7,00,300 (85.22%) was spent on antimicrobials.
Conclusion
Considering the complexities medical decision making and quality of care, the role of cost needs to take a major role in therapeutic options. There is a need to develop value-based policies, which strive to achieve the best clinical outcomes while also accounting for cost-effectiveness, polypharmacy and development of antimicrobial resistance.