Impact of neutropenic complications on short-term disability in patients with cancer receiving chemotherapy

Abstract

Objectives: The study examined the impact of chemotherapy-induced neutropenic complications (CINC), defined as neutropenia with fever or infection, on short-term disability (STD) among cancer patients receiving chemotherapy.

Methods: The key outcome metrics were average monthly STD days and associated indirect costs. Patients with and without CINC were propensity score (PS) matched. Multivariate regressions were conducted on PS-matched cohorts to estimate the marginal impact of CINC.

Results: A total of 280 patients with CINC were PS-matched to 280 patients without CINC. Compared with matched patients, patients with CINC on average experienced 0.9 more STD day (3.2 vs. 2.3, p=0.046) and $155 more in indirect costs ($549 vs. 394, p=0.050) per month. After multivariate adjustment, patients with CINC experienced 1.0 more STD day (p=0.029), and incurred $200 more in indirect cost (p=0.016) per month.

Conclusions: Patients with CINC experience significantly greater STD leave than patients with no neutropenic complications from cancer chemotherapy. The overall study sample only included patients from large self-insured employers in the US and may not reflect the work loss experience of all employed patients in the US or other countries. Indirect costs associated with absenteeism and presenteeism were not measured.

Keywords::

• chemotherapy-induced neutropenia complications
• propensity score matching
• work loss

Acknowledgments

Declaration of interest: This study and the publication of this article were funded by Amgen Inc.

D.H. and R.L.B. are employees of Amgen, Inc. They participated in the study design, interpretation of the data, and editing of the manuscript. The data analysis was carried out by Thomson Reuters, funding for this contribution was provided by Amgen Inc. X.S., R.F. and K.R. are employees of Thomson Reuters.

The authors thank Anthony Masaquel for his participation at the early stage of this study when he was an employee of Amgen Inc.

Notes

* Chemotherapy class antimitotic and anthracyclines were excluded from the matching because of multicollinearity.