Glossary
January 16, 2009 – Jennifer M. Gangloff
Breaking News from ASCO
June 09, 2006 – Staff Reports
House Call
June 09, 2006 – Jay Thomas, MD, PhD
Breast Cancer & MDS
January 09, 2009 – Elizabeth Whittington
Bookshelf
June 09, 2006 – Kathy LaTour
Web Exclusive: Follow-Up Care for Skin Cancer
June 09, 2006 – The National Cancer Institute
Weighing Prevention Versus Cost
June 09, 2006 – Melissa Knopper
Diagnosing Skin Cancer
June 09, 2006 – Susan R. Peck, PhD
Sharing a Lifetime
June 09, 2006
Sunburn Reasons & Remedies
June 09, 2006 – Monica Zangwill, MD
Inherited Syndromes Link Cancers
June 09, 2006 – Elizabeth Whittington
Future Risk for Survivors
June 09, 2006 – Rabiya S. Tuma, PhD
Nature's Spoils
June 09, 2006 – Elizabeth Whittington
The Discovery of Taxol
June 09, 2006 – Frank Stephenson
Melanoma: The Other Skin Cancer
June 09, 2006 – Elizabeth Whittington
Picture Not Perfect
June 09, 2006 – Elizabeth Whittington
Science of Suncreen
June 09, 2006 – Elizabeth Whittington
Planning for Death
June 09, 2006 – Elizabeth Whittington
Does Heaven Exist?
June 09, 2006 – Jo Cavallo
To Be or Not To Be: Is That the Right Question?
June 09, 2006 – Harvey Max Chochinov, MD PhD
Is It Time to Change the Design of Clinical Trials?
June 09, 2006 – Alice McCarthy
Drink Up
June 09, 2006 – Elizabeth Whittington
A Life Well-Lived
June 09, 2006 – Deborah Lang Hampton
Web Exclusive: Caregivers Often Neglect Their Mental Health
June 09, 2006 – The American Cancer Society
Letters from Our Readers
June 09, 2006
Message from the Editor-at-Large
June 09, 2006 – Kathy LaTour
Choosing a Counselor
June 09, 2006 – Elizabeth Whittington
Tips for Preventing Infection
June 09, 2006 – Elizabeth Whittington
Cancer as a Legacy
June 09, 2006 – Kathy LaTour
Fighting Cancer Together
June 09, 2006 – Elizabeth Whittington
Running on Empty
June 09, 2006 – Melissa Knopper
The Blame Game
June 09, 2006 – Kathy LaTour
People & Places
June 09, 2006 – Elizabeth Whittington
A Beautiful Day: The Story of a Son's Loss
June 09, 2006 – Kevin Cropp
Surf & Turf
June 09, 2006 – Jennifer M. Gangloff
Nonmelanoma Skin Cancer: Saving Your Skin
June 09, 2006 – Monica Zangwill, MD
Confronting Death
June 09, 2006 – Jo Cavallo
Glossary
January 16, 2009 – Jennifer M. Gangloff
Breaking News from ASCO
June 09, 2006 – Staff Reports
House Call
June 09, 2006 – Jay Thomas, MD, PhD
Breast Cancer & MDS
January 09, 2009 – Elizabeth Whittington
Bookshelf
June 09, 2006 – Kathy LaTour
Web Exclusive: Follow-Up Care for Skin Cancer
June 09, 2006 – The National Cancer Institute
Currently Viewing
Weighing Prevention Versus Cost
June 09, 2006 – Melissa Knopper
Sharing a Lifetime
June 09, 2006
Sunburn Reasons & Remedies
June 09, 2006 – Monica Zangwill, MD
Inherited Syndromes Link Cancers
June 09, 2006 – Elizabeth Whittington
Future Risk for Survivors
June 09, 2006 – Rabiya S. Tuma, PhD
Nature's Spoils
June 09, 2006 – Elizabeth Whittington
The Discovery of Taxol
June 09, 2006 – Frank Stephenson
Melanoma: The Other Skin Cancer
June 09, 2006 – Elizabeth Whittington
Picture Not Perfect
June 09, 2006 – Elizabeth Whittington
Science of Suncreen
June 09, 2006 – Elizabeth Whittington
Planning for Death
June 09, 2006 – Elizabeth Whittington
Does Heaven Exist?
June 09, 2006 – Jo Cavallo
To Be or Not To Be: Is That the Right Question?
June 09, 2006 – Harvey Max Chochinov, MD PhD
Is It Time to Change the Design of Clinical Trials?
June 09, 2006 – Alice McCarthy
Drink Up
June 09, 2006 – Elizabeth Whittington
A Life Well-Lived
June 09, 2006 – Deborah Lang Hampton
Web Exclusive: Caregivers Often Neglect Their Mental Health
June 09, 2006 – The American Cancer Society
Letters from Our Readers
June 09, 2006
Message from the Editor-at-Large
June 09, 2006 – Kathy LaTour
Choosing a Counselor
June 09, 2006 – Elizabeth Whittington
Tips for Preventing Infection
June 09, 2006 – Elizabeth Whittington
Cancer as a Legacy
June 09, 2006 – Kathy LaTour
Fighting Cancer Together
June 09, 2006 – Elizabeth Whittington
Running on Empty
June 09, 2006 – Melissa Knopper
The Blame Game
June 09, 2006 – Kathy LaTour
People & Places
June 09, 2006 – Elizabeth Whittington
A Beautiful Day: The Story of a Son's Loss
June 09, 2006 – Kevin Cropp
Surf & Turf
June 09, 2006 – Jennifer M. Gangloff
Nonmelanoma Skin Cancer: Saving Your Skin
June 09, 2006 – Monica Zangwill, MD
Confronting Death
June 09, 2006 – Jo Cavallo

Weighing Prevention Versus Cost

Supportive care drugs that can increase white blood cell count and prevent costly infections can also be expensive.  

BY Melissa Knopper
PUBLISHED June 09, 2006

Growth factors, such as Neupogen or Neulasta, can be expensive. One course to prevent neutropenia costs $1,900 to $2,800, and patients typically receive it with each chemotherapy cycle.

“Concern about cost is a little short-sighted because hospitalization with febrile neutropenia is also associated with considerable cost,” says Gary Lyman, MD. A recent study in Cancer found that the average hospital bill was almost $20,000 per episode. “The growth factors, while expensive, can actually be cost-saving. When the risk of neutropenia is 20 percent or higher, you actually save money by avoiding hospitalization.”

The American Society of Clinical Oncology updated its guidelines earlier this year to call for growth factors if a patient has at least a 20 percent chance of febrile neutropenia as a result of chemotherapy, a recommendation already made by the National Comprehensive Cancer Network, an alliance of the country’s top 20 cancer centers. (The previous ASCO guideline was 40 percent or higher.) The cost efficacy is determined by the cost per day of hospitalization. The initial model, and the one ASCO and most insurance companies go by is $1,000 per day. An updated analysis averaged the cost at over $1,700 per day, lowering the risk threshold to about 20 percent.

But the cost of the drug is not the only issue patients and health officials are concerned with when determining when to use growth factors. Delay or reduction of chemotherapy during times the patient has an infection is also a factor.

Relatively healthy patients who are not at high risk for infection may not need growth factors unless they are on higher doses of chemotherapy, but patients who are elderly, have compromised immune systems or receive dose-dense chemotherapy or stem cell transplants are in greater need of growth factors.

Medicare and private insurance companies typically pay a portion of the cost. If the drug is administered at a hospital or doctor’s office, Medicare will cover it as an injectable drug. Patients with Medicare prescription drug coverage will be able to give themselves the injections at home, but convenience is often accompanied with a high co-payment. Amgen’s program, SafetyNet, provides Neupogen or Neulasta to uninsured or underinsured patients through a doctor referral. For information on SafetyNet, call 800-272-9376.

Be the first to discuss this article on CURE's forum. >>
Talk about this article with other patients, caregivers, and advocates in the General Discussions CURE discussion group.

Related Articles

1
×

Sign In

Not a member? Sign up now!
×

Sign Up

Are you a member? Please Log In