title: Cost of childhood acute lymphoblastic leukemia care in Shanghai, China.
abstract: BACKGROUND
  Acute lymphoblastic leukemia (ALL) is the most common and curable malignant pediatric disease in children. In low- and middle-income countries, however, economic factors prevent many patients from receiving complete treatment, even as government and insurance entities lack complete data on the costs for ALL therapies. Here, we analyzed the overall costs for pediatric ALL therapies and their constitutive elements.
  
  
  METHODS
  All cost information was drawn from our hospital database. We analyzed the costs of 45 newly diagnosed children with ALL from May 2005 to June 2006; 20 were classified into low-risk group, 25 into medium-risk group, and all had completed the ALL-2005 protocol treatment. Forty cases were B-lineage, four were T-lineage, and one was double-lymphoid lineage.
  
  
  RESULTS
  Average total clinic expense per person was US $3,694.58 +/- 1,376.85. Average total in-hospital expense per patient was US $7,299.48 +/- 6,526.39, with a large individual difference. Medicine and laboratory test costs represented 40.5% and 21.5%, respectively. Patients stayed at home or attended clinic for more than 90% of the therapy period. In-hospital and clinic constituted 66.4% and 33.6% of costs, respectively. Costs among risk groups and with/without severe complications differed significantly (P < 0.05). Thirty-month event-free survivals were 94.14% and 82.81% for the low- and medium-risk groups, respectively.
  
  
  CONCLUSIONS
  Risk group and severe complications were main factors affecting total medical costs. Average overall costs for childhood ALL in this study were less than US $11,000, with reasonable clinical results.
authors.affiliation: Department of Hematology/Oncology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Yin
authors.initials: Y
authors.lastname: Liu
authors.forename: Jing
authors.initials: J
authors.lastname: Chen
authors.forename: JingYan
authors.initials: J
authors.lastname: Tang
authors.forename: Shengxing
authors.initials: S
authors.lastname: Ni
authors.forename: Huiliang
authors.initials: H
authors.lastname: Xue
authors.forename: Ci
authors.initials: C
authors.lastname: Pan
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002681:China; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007223:Infant; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000191:economics / Q000628:therapy*