Cost-effectiveness of home-based care of febrile neutropenia in children with cancer

A recent article by Dr Michelle Tew and Professor Kim Dalziel from the Health Economics Unit and colleagues at the Royal Children’s Hospital, Murdoch Children’s Research Institute, University of Technology Sydney and Peter MacCallum Cancer Centre was published in Pediatric Blood & Cancer.

The study evaluated the cost, benefits and cost-effectiveness of implementing a novel pathway of care involving home-based care of febrile neutropenia (FN) in children with cancer compared to inn-hospital FN care. A decision tree was developed to model the decision paths (expected sequence of events) before and after implementation of the home-based FN program. The model applied data from prospectively collected clinical data and costs extracted from hospital administrative records. The study showed that the program is cost-effective from both the health care and societal perspectives. Although managing children at home increased the duration of care, this model of care substantially reduced in-hospital length of stay translating to significantly lower health care costs of both low-risk and high-risk groups, as compared to standard inpatient care. Importantly, children were effectively and safely managed on the programme without adverse impacts on patient QoL and clinical outcomes including mortality. This provides a strong case to justify the implementation was well as evidence to support the continuity of the program.