Evaluating cost-effectiveness in outpatient management of medical complications in cancer patients.
It has been estimated that 85% to 90% of all cancer patient care occurs in the outpatient setting, and the vast majority of chemotherapy is administered in the outpatient setting either in physician offices or hospital clinics. With the introduction of white blood cell growth factors in the early 1990s, dose-intensive regimens either for curative or palliative therapy became more common. Since that time, major dose-limiting toxicities have become gastrointestinal mucositis and chemotherapy-induced thrombocytopenia. Patient-reported symptoms have also become important as the changing financing and reimbursement for health care shifts the focus to a patient-centered, value-oriented approach in hematology and medical oncology. This paper will examine advances in the management of three common complications of antineoplastic therapy, mucositis, thrombocytopenia, and fatigue, with a particular emphasis on cost-effectiveness as it relates to value in health care.
University of Texas, M.D. Anderson Cancer Center, Texas Medical Center, Houston 77030, USA.
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Rubenstein
D003362:Cost-Benefit Analysis; D005221:Fatigue / Q000191:economics* / Q000209:etiology / Q000628:therapy; D006801:Humans; D009061:Mouth Mucosa / Q000187:drug effects / Q000473:pathology; D009369:Neoplasms / Q000150:complications* / Q000191:economics* / Q000628:therapy; D010045:Outpatients; D013280:Stomatitis / Q000139:chemically induced / Q000188:drug therapy* / Q000191:economics*; D013921:Thrombocytopenia / Q000139:chemically induced / Q000188:drug therapy* / Q000191:economics*