Costs of human resources in delivering cancer chemotherapy and managing chemotherapy-induced neutropenia in community practice

Research on the costs of delivering cancer chemotherapy has typically focused on drug administration, but assessing the overall costs must also consider the human resources necessary. Furthermore, supportive care, such as using colony- stimulating factors to manage chemotherapy-induced neutropenia, can greatly affect the costs of care. This study evalu- ated the human resource costs associated with delivering chemotherapy and managing chemotherapy-induced neutro- penia in the community oncology setting. A model of medical visits associated with 21-day chemotherapy regimens and common approaches to managing neutropenia was defined. Four hundred medical professionals at 20 community oncology practices in the United States completed a semistructured interview to provide data on practice patterns and the time and costs of performing medical tasks. The results indicate that chemotherapy- and neutropenia-related medi- cal visits require substantial human resource time and costs. The human resource cost of a single treatment with pegfil- grastim or filgrastim was equivalent, but, because of the greater number of visits required with filgrastim, the total time and costs with pegfilgrastim (2.4 hours and $57.30) were less than those with filgrastim (14.8 hours and $364.66). This study provides important data on medical visits that can be used in future analyses to model the implications of chemotherapy and supportive care for anemia and neutropenia. Implementing strategies to lessen the number of vis- its can reduce human resource time and costs and help focus these resources on other treatment-related activities.