Stem cell transplantations in patients with malignant lymphoma: costs in a Dutch university hospital in the period 1984-1995.
In the past 15 years, perspectives on treatment of patients with relapsed non-Hodgkin's lymphoma have changed. This has had important consequences for the costs of treatment. We conducted a retrospective study comparing the costs of four different treatment modalities in a university hospital in The Netherlands. The first group of patients received an autologous bone marrow transplantation (ABMT) and was kept in reverse barrier nursing. Their average total treatment costs amounted to US$26,539. Patients in the second group also received an ABMT but stayed on the normal hematology ward. The total average treatment costs for this group were US$20,806. In the third group, patients were transplanted with whole blood. Their average total treatment costs amounted to US$17,000. Patients in the fourth group received transplantation of autologous PBPC and their average total treatment costs were US$14,205. The decline in costs over time was mainly due to shorter hospitalization, less blood transfusions, and less parenteral nutrition. These factors also likely led to an improvement in patients' quality of life. The results of this study show that the progression in stem cell transplantation (SCT) techniques has been accompanied by significant benefits for patients and a decrease in costs.
Uyl-de Groot
C A
CA
Institute for Medical Technology Assessment, Erasmus University Rotterdam, The Netherlands.
Ossenkoppele
G J
GJ
Buijt
I
I
Huijgens
P C
PC
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001772:Blood Cell Count; D001803:Blood Transfusion / Q000191:economics; D016026:Bone Marrow Transplantation / Q000191:economics; D002330:Carmustine / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D018380:Hematopoietic Stem Cell Transplantation / Q000191:economics*; D017721:Hospital Costs; D006757:Hospital Units / Q000191:economics; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007902:Length of Stay; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy / Q000191:economics / Q000628:therapy*; D008558:Melphalan / Q000008:administration & dosage; D009426:Netherlands; D010288:Parenteral Nutrition / Q000191:economics; D010356:Patient Isolation / Q000191:economics; D011034:Podophyllotoxin / Q000008:administration & dosage; D011241:Prednisone / Q000008:administration & dosage; D012189:Retrospective Studies; D014182:Transplantation, Autologous / Q000191:economics; D014750:Vincristine / Q000008:administration & dosage
D003561:Cytarabine; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011034:Podophyllotoxin; D008558:Melphalan; D002330:Carmustine; D011241:Prednisone