Inpatient treatment of febrile neutropenia in children with cancer is
neither cost-effective nor preferred by patients, according to results of a
study published online.
Oliver Teuffel, MD, MsC, and colleagues from the Hospital for
Sick Children in Toronto created a cost-utility model that compared four
treatment models for children with febrile neutropenia, including that the
child was treated the whole time in the hospital with IV antibiotics; that the
child was given IV antibiotics, then given an early discharge; that the child
was managed entirely at home using IV antibiotics; or that the child was
managed at home with oral antibiotics.
The researchers said home IV antibiotics was the most cost-effective
strategy compared with oral antibiotics at home, with a cost of $2,732 vs.
$2,757. Any treatment in the hospital increased costs by about $3,000, even if
the child was sent home early. As expected, the hospital IV treatment was the
least cost-effective, totaling about $15,000.
Modeling the cost-effectiveness of the four proposed treatment
strategies indicated that the substantially higher costs of inpatient
management could not be justified on the basis of safety and efficacy
considerations or patients preferences, the researchers wrote.
It is interesting to note that health utilities for hospital IV were
rated lower compared with home IV therapy but higher compared with [oral
antibiotics at home].
However, the researchers said there was significant patient variability,
and the individual patients needs should be assessed before considering
changing management approaches.
Disclosure: The researchers reported no relevant financial disclosures.