title: Induction-related cost of patients with acute myeloid leukaemia in France.
abstract: OBJECTIVE
  The economic profile of acute myeloid leukaemia (AML) is badly known. The few studies published on this disease are now relatively old and include small numbers of patients. The purpose of this retrospective study was to evaluate the induction-related cost of 500 patients included in the AML 2001 trial, and to determine the explanatory factors of cost.
  
  
  METHODS
  "Induction" patient's hospital stay from admission for "induction" to discharge after induction.
  
  
  METHODS
  The study was performed from the French Public Health insurance perspective, restrictive to hospital institution costs. The average management of a hospital stay for "induction" was evaluated according to the analytical accounting of Besançon University Teaching Hospital and the French public Diagnosis-Related Group database. Multiple linear regression was used to search for explanatory factors.
  
  
  METHODS
  Only direct medical costs were included: treatment and hospitalisation.
  
  
  RESULTS
  Mean induction-related direct medical cost was estimated at €41,852 ± 6,037, with a mean length of hospital stay estimated at 36.2 ± 10.7 days. After adjustment for age, sex and performance status, only two explanatory factors were found: an additional induction course and salvage course increased induction-related cost by 38% (± 4) and 15% (± 1) respectively, in comparison to one induction. These explanatory factors were associated with a significant increase in the mean length of hospital stay: 45.8 ± 11.6 days for 2 inductions and 38.5 ± 15.5 if the patient had a salvage course, in comparison to 32.9 ± 7.7 for one induction (P < 10⁻⁴). This result is robust and was confirmed by sensitivity analysis.
  
  
  CONCLUSIONS
  Consideration of economic constraints in health care is now a reality. Only the control of length of hospital stay may lead to a decrease in induction-related cost for patients with AML.
authors: Department of Pharmacy, University Hospital of Besançon, 25030, Besançon, France.
authors: Virginie
authors: V
authors: Nerich
authors: Bruno
authors: B
authors: Lioure
authors: Maryline
authors: M
authors: Rave
authors: Christian
authors: C
authors: Recher
authors: Arnaud
authors: A
authors: Pigneux
authors: Brigitte
authors: B
authors: Witz
authors: Martine
authors: M
authors: Escoffre-Barbe
authors: Marie-Pierre
authors: MP
authors: Moles
authors: Eric
authors: E
authors: Jourdan
authors: Jean Yves
authors: JY
authors: Cahn
authors: Marie-Christine
authors: MC
authors: Woronoff-Lemsi
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000191:economics* / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D002986:Clinical Trials as Topic / Q000191:economics; D017326:Clinical Trials, Phase III as Topic / Q000191:economics; D003365:Costs and Cost Analysis; D016527:Drug Costs; D005260:Female; D005602:France; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007902:Length of Stay / Q000191:economics; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000191:economics*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D015337:Multicenter Studies as Topic / Q000191:economics; D009313:National Health Programs / Q000191:economics; D010343:Patient Admission / Q000191:economics; D010351:Patient Discharge / Q000191:economics; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000191:economics; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult