Open Access Research article

Economic costs of chemotherapy-induced febrile neutropenia among patients with non-Hodgkin’s lymphoma in European and Australian clinical practice

Derek Weycker1*, Aurelie Danel2, Anne Marciniak3, Kate Bendall4, Michael Lipsitz1 and Ruth Pettengell5

Author Affiliations

1 Policy Analysis Inc. (PAI), 4 Davis Court, Brookline, MA, 02445, USA

2 Amgen Europe, Dammastrasse 23, Zug, 6300, Switzerland

3 Amgen Ltd, 1 Uxbridge Business Park, Sanderson Road, Uxbridge, UB8 1DH, UK

4 Cascade, 3rd Floor, 3 Copthall Avenue, London, EC2R 7BH, UK

5 Department of Haematology, St. George’s University of London, Cranmer Terrace, London, SW17 0RE, UK

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BMC Cancer 2012, 12:362  doi:10.1186/1471-2407-12-362

Published: 22 August 2012



Economic implications of chemotherapy-induced febrile neutropenia (FN) in European and Australian clinical practice are largely unknown.


Data were obtained from a European (97%) and Australian (3%) observational study of patients with non-Hodgkin’s lymphoma (NHL) receiving CHOP (±rituximab) chemotherapy. For each patient, each cycle of chemotherapy within the course, and each occurrence of FN within cycles, was identified. Patients developing FN in a given cycle (“FN patients”), starting with the first, were matched to those who did not develop FN in that cycle (“comparison patients”), irrespective of subsequent FN events. FN-related healthcare costs (£2010) were tallied for the initial FN event as well as follow-on care and FN events in subsequent cycles.


Mean total cost was £5776 (95%CI £4928-£6713) higher for FN patients (n = 295) versus comparison patients, comprising £4051 (£3633-£4485) for the initial event and a difference of £1725 (£978-£2498) in subsequent cycles. Among FN patients requiring inpatient care (76% of all FN patients), mean total cost was higher by £7259 (£6327-£8205), comprising £5281 (£4810-£5774) for the initial hospitalization and a difference of £1978 (£1262-£2801) in subsequent cycles.


Cost of chemotherapy-induced FN among NHL patients in European and Australian clinical practice is substantial; a sizable percentage is attributable to follow-on care and subsequent FN events.

Febrile neutropenia; Costs and cost analysis; Non-Hodgkin’s lymphoma