Cost Analysis Of Febrile Neutropenia (Fn) Management In Three Tumour Types In Germany

20651 Background: FN is the most frequent dose-limiting toxicity of myelosuppressive chemotherapy (CT). To date there are few data on the costs of FN management in Germany. Methods: Prospective, multicentre, observational, longitudinal study with lymphoma, non small cell lung cancer (NSCLC) and primary breast cancer (PBC) patients (pts). Pts were enrolled consecutively at the start of 1st or 2nd line (immuno-)CT in 4 German hospitals (01/05–12/06). FN was defined as fever >38ºC and ANC <1 × 109/L. If nadir ANC was unavailable, febrile leukopenia (FL) was assessed (fever >38ºC and LC <2 × 109/L). Clinical and resource use data were collected from medical charts. FN associated costs are presented from the provider perspective. Results: Medical charts from 325 pts (47% lymphoma; 37% NSCLC; 16% PBC; 46% women; 38% age ≥65 yrs) were reviewed. FN/FL occurred in 22% of lymphoma, 8% of NSCLC, 27% of PBC and 18% of all pts. In total, 68 FN/FL episodes were identified in 58 pts (see table). Fifty-five FN/FL episodes were associated with ≥1 hospital stay (lymphoma n=34, NSCLC n=10, PBC n=11). Mean±SD cost per FN/FL episode requiring hospital treatment amounted to €3950±4961 (95% CI: 2569, 5331) and varied between €4808±5839 for lymphoma (95% CI: 2666, 6949), €3627±4120 for NSCLC (95% CI: 680, 6574) and €1827±795 for PBC (95% CI: 1293, 2361). Basic hospital costs represented 55% of total costs in lymphoma, 71% in NSCLC and 83% in PBC. Drug treatment made up 22% of total costs in lymphoma, 11% in NSCLC and 9% in PBC pts. Diagnostics generated 8–11% of total direct costs. Conclusions: FN/FL costs vary by tumour type and are highest for pts with lymphoma. Main cost drivers are hospitalisation and drugs. FN/FL pts (%) All (n=58) Lymphoma (n=35) NSCLC (n=9) PBC (n=14) Regimen 54% CHOP-like 80% platinum-based 100% anthracycline-based Female 33 (57) 16 (46) 3 (33) 14 (100) Age ≥ 65 22 (38) 16 (46) 3 (33) 3 (21) ECOG ≥ 2 6 (10) 4 (11) 2 (22) 0 Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration Amgen Amgen Amgen Amgen, Eli Lilly