This Article Full Text Full Text (PDF) eLetters: Submit a response to this article Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services E-mail this article link to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints/Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Calhoun, E. A. Articles by Bennett, C. L. Search for Related Content PubMed PubMed Citation Articles by Calhoun, E. A. Articles by Bennett, C. L.

Evaluating the Total Costs of Chemotherapy-Induced Toxicity: Results from a Pilot Study with Ovarian Cancer Patients

The Institute for Health Services Research and Policy Studies, Department of Obstetrics and Gynecology, the Robert H. Lurie Comprehensive Cancer Center, Northwestern University Medical School, Department of Medicine, Division of Hematology/Oncology, Chicago, Illinois, USA and the Chicago VA Healthcare System/Lakeside Division, Chicago, Illinois, USA

Correspondence: Elizabeth A. Calhoun, Ph.D., The Institute for Health Services Research and Policy Studies, Department of Obstetrics and Gynecology, the Robert H. Lurie Comprehensive Cancer Center, Northwestern University Medical School, 339 E. Chicago Avenue, Room 717, Chicago, Illinois 60611, USA. Telephone 312-503-1544; Fax: 312-503-2936; e-mail: e-calhoun{at}northwestern.edu.

Purpose. While chemotherapy-related toxicities affect cancer patients' activities of daily living and result in large expenditures of medical care for treatment, few studies have assessed the out-of-pocket and indirect costs incurred by patients who experience toxicity. The objective of this study was to evaluate the feasibility of obtaining detailed and comprehensive cost information from patients who experienced neutropenia, thrombocytopenia, or neurotoxicity during treatment.

Methods. Ovarian cancer patients who experienced chemotherapy-associated hematologic or neurologic toxicities were asked to record detailed information about hospitalization, laboratories, physician visits, phone calls, home visits, medication, medical devices, lost productivity, and caregivers. Resource estimates were converted into cost units, with direct medical cost estimates based on hospital cost-accounting data and indirect costs (i.e., productivity loss) on modified labor force, employment, and earnings data.

Results. Direct medical costs were highest for neutropenia (mean of $7,546/episode), intermediate for thrombocytopenia (mean of $3,268/episode), and lowest for neurotoxicity (mean of $688/episode). Indirect costs relating to patient and caregiver work loss and payments for caregiver support were substantial, accounting for $4,220, $3,834, and $4,282 for patients who developed neurotoxicity, neutropenia, and thrombocytopenia, respectively. The total costs of chemotherapy-related neurotoxicity, neutropenia, and thrombocytopenia were $4,908, $11,830, and $7,550.

Conclusion. Our study has shown that, with the assistance of patients who are experiencing toxicity, estimation of the total costs of cancer-related toxicities is feasible. Indirect costs, while not included in prior estimates of the costs of toxicity studies, accounted for 34% to 86% of the total costs of cancer supportive care.

Key Words. Costs • Toxicities • Chemotherapy

This article has been cited by other articles:

				G. Dranitsaris, W. Cottrell, B. Spirovski, and S. Hopkins Economic analysis of albumin-bound paclitaxel for the treatment of metastatic breast cancer Journal of Oncology Pharmacy Practice, June 1, 2009; 15(2): 67 - 78. [Abstract] [PDF]

				C. L. Bennett and E. A. Calhoun Evaluating the Total Costs of Chemotherapy-Induced Febrile Neutropenia: Results from a Pilot Study with Community Oncology Cancer Patients Oncologist, April 1, 2007; 12(4): 478 - 483. [Abstract] [Full Text] [PDF]

				J. R. Adams, C. Angelotta, and C. L. Bennett When the Risk of Febrile Neutropenia Is 20%, Prophylactic Colony-Stimulating Factor Use Is Clinically Effective, but Is It Cost-Effective? J. Clin. Oncol., July 1, 2006; 24(19): 2975 - 2977. [Full Text] [PDF]

				N. Casadevall, P. Durieux, S. Dubois, F. Hemery, E. Lepage, M.-C. Quarre, G. Damaj, S. Giraudier, A. Guerci, G. Laurent, et al. Health, economic, and quality-of-life effects of erythropoietin and granulocyte colony-stimulating factor for the treatment of myelodysplastic syndromes: a randomized, controlled trial Blood, July 15, 2004; 104(2): 321 - 327. [Abstract] [Full Text] [PDF]

				The Chronic Prostatitis Collaborative Research Net The Economic Impact of Chronic Prostatitis Arch Intern Med, June 14, 2004; 164(11): 1231 - 1236. [Abstract] [Full Text] [PDF]