Liou S Y, Stephens J M, Carpiuc K T, Feng W, Botteman M F, Hay J W
Pharmerit North America LLC, Bethesda, Maryland 20814, USA.
Clin Drug Investig. 2007;27(6):381-96. doi: 10.2165/00044011-200727060-00002.
Patients receiving cancer treatments commonly experience haematological adverse effects (AEs) related to chemotherapy or molecularly targeted therapies, which may be associated with high healthcare costs. The objective of this review was to summarise the published literature on the economic burden of neutropenia, thrombocytopenia and anaemia as AEs of cancer treatment.
A systematic search of the medical literature published between 1990 and 2006 was conducted using PubMed/MEDLINE, EMBASE, BIOSIS, related article links and supplemental searches. References selected for inclusion were prospective or retrospective studies specifically designed to examine the burden of illness, direct medical costs, indirect costs and/or cost drivers associated with neutropenia, thrombocytopenia and anaemia in adult cancer patients. All costs are reported as originally published and adjusted to 2006 US dollars.
In the US, the cost of neutropenia ranged from $US 1893 (2006 value $US 2632) per outpatient episode to $US 38,583 ($US 49,917) per febrile neutropenia hospitalisation. For countries outside the US, the cost of neutropenia appeared to be lower. The cost of thrombocytopenia ranged from $US 1035 ($US 1395) to $US 5328 ($US 7635) per cycle or episode in the US. Costs attributable to anaemia ranged from $US 18,418 ($US 22,775) to $US 69,478 ($US 93,454) per year in the US. The costs of AEs for patients with haematological malignancies appeared to be up to 2-3 times higher than those for patients with solid tumours. Economic studies of the cost of haematological AEs specific to new molecularly targeted treatments for haematological malignancy have not been published.
Chemotherapy-related haematological AEs result in a substantial economic burden on patients, payers, caregivers and society in general. Because of their burden, the frequency and severity of these toxicities should be one of the key factors in the selection of optimal treatments for patients with cancer, especially those with haematological malignancies. Future research is needed to assess the economic burden of AEs associated with new molecularly targeted treatments for haematological malignancies.
接受癌症治疗的患者通常会经历与化疗或分子靶向治疗相关的血液学不良反应（AE），这可能会带来高昂的医疗成本。本综述的目的是总结已发表的关于中性粒细胞减少、血小板减少和贫血作为癌症治疗不良反应的经济负担的文献。
使用PubMed/MEDLINE、EMBASE、BIOSIS、相关文章链接和补充检索对1990年至2006年发表的医学文献进行系统检索。入选的参考文献为专门设计用于研究成年癌症患者中性粒细胞减少、血小板减少和贫血相关的疾病负担、直接医疗成本、间接成本和/或成本驱动因素的前瞻性或回顾性研究。所有成本均按最初发表的报告，并调整为2006年美元。
在美国，每次门诊中性粒细胞减少的成本从1893美元（2006年价值2632美元）到每例发热性中性粒细胞减少住院38583美元（49917美元）不等。在美国以外的国家，中性粒细胞减少的成本似乎较低。在美国，每次血小板减少周期或发作的成本从1035美元（1395美元）到5328美元（7635美元）不等。美国每年贫血导致的成本从18418美元（22775美元）到69478美元（93454美元）不等。血液系统恶性肿瘤患者的不良反应成本似乎比实体肿瘤患者高出2至3倍。尚未发表关于血液系统恶性肿瘤新分子靶向治疗特有的血液学不良反应成本的经济学研究。
化疗相关的血液学不良反应给患者、支付方、护理人员和整个社会带来了巨大的经济负担。由于其负担，这些毒性的频率和严重程度应成为为癌症患者，尤其是血液系统恶性肿瘤患者选择最佳治疗方法的关键因素之一。需要未来的研究来评估与血液系统恶性肿瘤新分子靶向治疗相关的不良反应的经济负担。
