OBJECTIVES: To describe the clinical characteristics, resource utilization and cost of management (COM) of febrile neutropenia (FN) in oncology inpatients.

METHODS: This is a descriptive and retrospective study of a cohort of patients hospitalized due to FN in Clínica SOMA - a health care institution in Medellín (Colombia) - from 2017 to 2019. The costs were extracted from the review of medical records from diagnosis of FN until discharge or death. Costs were classified as laboratories, medications, hospital length-of-stay (LOS), and specialist physician fees. FN episodes were classified as high-risk or low-risk according to the MASCC-scale. Official government manual and drug price information system were used to estimate the cost, which were expressed in 2019 US dollars (US$). The exchange rate applied was 3,278 colombian pesos per US$.

RESULTS: Forty-four FN episodes were included. Median age was 61 years (IQR: 53-72), female (52.3%). Solid tumors accounted for 68.8%. The most frequent cancer diagnoses were colorectal (13.6%), breast (11.4%) and lung (9.1%). In terms of oncology treatments, 14 (31.8%) patients were in first-line; 14 (31.8%) in the adjuvant/neoadjuvant setting; and 5 (11.4%), in second-line (2L); 15 (34.0%) episodes occurred in the high-risk setting. Mean LOS per episode was 5.7 ±2.9 days. All patients were discharged alive. Highest COM was found in the 2L group (mean +/- sd: US$1,382±610). COM was higher in high-risk patients ($1,192 ± 1,025) as compared to low-risk (US$770 ± 581). The median overall COM was $633 (range:US US$262- US$3,376) per episode, being hospital LOS the main driver cost.

CONCLUSIONS: Febrile neutropenia occurred mainly in advanced-stage solid tumors and in MASCC low-risk patients. Higher costs in this cohort were found in long hospital length of stay, and 2L or high-risk patients.