Cost analysis of HLA-identical sibling and voluntary unrelated allogeneic bone marrow and peripheral blood stem cell transplantation in adults with acute myelocytic leukaemia or acute lymphoblastic leukaemia.
Allogeneic stem cell transplantation (SCT) is one of the most expensive medical procedures. However, only a few studies to date have addressed the costs of HLA-identical sibling transplantation and only one study has reported costs of unrelated transplantation. No recent cost analysis with a proper follow-up period and donor identification expenses is available on related or voluntary matched unrelated donor (MUD) SCT for adult AML or ALL. Therefore, we calculated direct medical (hospital) costs based on 97 adults who underwent HLA-identical sibling bone marrow transplantation (BMT) or peripheral blood stem cell transplantation (PBSCT), and patients who received a graft from a MUD between 1994 and 1999. The average costs per transplanted patient were Euro 98,334 (BMT), Euro 151,754 (MUD), and Euro 98,977 (PBSCT), including donor identification expenses, 2 years follow-up and costs of patients who were not transplanted after they had been planned to receive an allograft. The majority of these costs was generated during the hospitalisation for graft infusion. For MUD transplants, nearly one-third of these costs was spent on the search for a suitable donor. For patients who were alive after 2 years, cumulative expenses were calculated to be Euro 103,509 (BMT), Euro 173,587 (MUD), and Euro 105,906 (PBSCT).
Institute for Medical Technology Assessment, Department of Health Care Policy and Management, Erasmus University Rotterdam, The Netherlands.
M
M
van Agthoven
M T
MT
Groot
L F
LF
Verdonck
B
B
Löwenberg
A V M B
AV
Schattenberg
M
M
Oudshoorn
A
A
Hagenbeek
J J
JJ
Cornelissen
C A
CA
Uyl-de Groot
R
R
Willemze
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000191:economics*; D003365:Costs and Cost Analysis; D005260:Female; D017048:Health Care Costs; D006648:Histocompatibility; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000191:economics / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000191:economics*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000191:economics / Q000628:therapy*; D014019:Tissue Donors; D014184:Transplantation, Homologous / Q000191:economics; D014185:Transplantation, Isogeneic / Q000191:economics