Evaluation of Direct Medical Costs Associated With High-Risk Febrile Neutropenia Among Cancer Patients in a Tertiary Care Center

Introduction The onset of febrile neutropenia (FN) demands dose reduction and usually temporary halting of chemotherapy, which could then affect the outcome of cancer treatment. In this study, we wanted to quantify the drugs used in treating febrile neutropenic episodes, the costs incurred as a result, and the outcomes of these episodes. Methods The study was a prospective observational study. Patients of either sex, of any age, and diagnosed with high-risk FN following cancer chemotherapy and hospitalized during the period of study were included. A total of 46 patients with 50 episodes of FN were enrolled. Data were collected from the department database and daily clinical notes and were entered into a pre-designed proforma. The drugs prescribed were classified as antibiotics and supportive medications. The drug cost of each episode was then calculated. The data were analysed using descriptive statistics. Results The mean age of participants was 26.66 years, with a median length of hospital stay of 10 days. This provides an estimate of the drug-related costs. A total of Rs. 8,21,731 was spent on drugs for the management of 50 episodes, and the average cost of an episode was Rs. 16,434. Of the total cost, Rs. 7,00,300 (85.22%) was spent on antimicrobials. Conclusion Considering the complexities of medical decision-making and quality of care, the role of cost needs to play a major role in therapeutic options. There is a need to develop value-based policies to achieve the best clinical outcomes while accounting for cost-effectiveness and polypharmacy.