title: Risk and healthcare costs of chemotherapy-induced neutropenic complications in women with metastatic breast cancer.
abstract: BACKGROUND
  The burden of chemotherapy-induced neutropenic complications (CINC) in women with metastatic breast cancer (MBC) is largely unknown and may differ across cancer populations due to variation in the characteristics of patients, their disease and their treatment.
  
  
  METHODS
  This study employed a retrospective cohort design and US healthcare claims data (2003-2009). For each woman in the study database who received myelotoxic chemotherapy for MBC, the first observed course and each cycle within the course were characterized. Risk and healthcare costs of CINC - by care setting - were descriptively analyzed on an overall basis by chemotherapy cycle and chemotherapy regimen.
  
  
  RESULTS
  Among 2,620 study subjects, most received chemotherapy with cyclophosphamide/doxorubicin (25%), docetaxel (20%) or paclitaxel (12%). Thirty-one percent of subjects received colony-stimulating factors (CSF) prophylactically in their first chemotherapy cycle and an additional 13% first received CSF prophylaxis after cycle one. CINC developed in 11% of subjects; among these subjects, 88% required inpatient care and 45% experienced CINC in the first cycle of chemotherapy. For CINC requiring inpatient care, costs averaged USD 12,869 (95% CI: USD 12,622-13,116), and for CINC requiring outpatient care only, USD 2,030 (CI: USD 1,925-2,135).
  
  
  CONCLUSIONS
  CINC is a clinically and economically important threat among women with MBC, and should be an important consideration in the treatment of this population.
authors.affiliation: Policy Analysis Inc., Brookline, MA 02445, USA. dweycker@pai2.com
authors.forename: Derek
authors.initials: D
authors.lastname: Weycker
authors.forename: John
authors.initials: J
authors.lastname: Edelsberg
authors.forename: Alex
authors.initials: A
authors.lastname: Kartashov
authors.forename: Rich
authors.initials: R
authors.lastname: Barron
authors.forename: Gary
authors.initials: G
authors.lastname: Lyman
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D015331:Cohort Studies; D003365:Costs and Cost Analysis; D003520:Cyclophosphamide / Q000009:adverse effects / Q000627:therapeutic use; D016208:Databases, Factual; D000077143:Docetaxel; D004317:Doxorubicin / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D017048:Health Care Costs; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009503:Neutropenia / Q000139:chemically induced* / Q000191:economics* / Q000209:etiology; D017239:Paclitaxel / Q000009:adverse effects / Q000627:therapeutic use; D012189:Retrospective Studies; D012307:Risk Factors; D043823:Taxoids / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D043823:Taxoids; D016179:Granulocyte Colony-Stimulating Factor; D000077143:Docetaxel; D004317:Doxorubicin; D003520:Cyclophosphamide; D017239:Paclitaxel