title: Pilot study of patient and caregiver out-of-pocket costs of allogeneic hematopoietic cell transplantation.
abstract: Patient/caregiver out-of pocket costs associated with hematopoietic cell transplantation (HCT) are not well known. We conducted a pilot study to evaluate patient/caregiver out-of-pocket costs in the first 3 months after allogeneic HCT. Thirty patients were enrolled at three sites. Before HCT, participants completed a baseline survey regarding household income and insurance coverage. Subsequently, they maintained a paper-based diary to track daily out-of-pocket expenses for the first 3 months after HCT. Telephone interviews were conducted to follow-up on the missing/incomplete diaries and on study completion. Twenty-five patients/caregivers completed the baseline survey. Among these, the median pre-tax household income was $66 500 (range, $30-$375 000) and 48% had to temporarily relocate close to the transplant center. Insurance coverage was managed care plan (56%), Medicaid (20%), Medicare (17%) and other (8%). Twenty-two patients/caregivers completed 4 diaries; the median out-of-pocket expenses were $2440 (range, $199-$13 769). Patients/caregivers who required temporary lodging had higher out-of-pocket expenses compared with those who did not (median, $5247 vs $716). Patients/caregivers can incur substantial out-of-pocket costs over the first 3 months, especially if they need to temporarily relocate close to the transplant center. Our study lays the foundation for future research on the early and long-term financial impact of allogeneic HCT on patients/caregivers.
authors.affiliation: National Marrow Donor Program, Minneapolis, MN 55413, USA. nmajhail@nmdp.org
authors.forename: N S
authors.initials: NS
authors.lastname: Majhail
authors.forename: J D
authors.initials: JD
authors.lastname: Rizzo
authors.forename: T
authors.initials: T
authors.lastname: Hahn
authors.forename: S J
authors.initials: SJ
authors.lastname: Lee
authors.forename: P L
authors.initials: PL
authors.lastname: McCarthy
authors.forename: M
authors.initials: M
authors.lastname: Ammi
authors.forename: E
authors.initials: E
authors.lastname: Denzen
authors.forename: R
authors.initials: R
authors.lastname: Drexler
authors.forename: S
authors.initials: S
authors.lastname: Flesch
authors.forename: H
authors.initials: H
authors.lastname: James
authors.forename: N
authors.initials: N
authors.lastname: Omondi
authors.forename: T L
authors.initials: TL
authors.lastname: Pedersen
authors.forename: E
authors.initials: E
authors.lastname: Murphy
authors.forename: K
authors.initials: K
authors.lastname: Pederson
mesh_terms: D000328:Adult; D000368:Aged; D064591:Allografts; D017028:Caregivers / Q000191:economics*; D003365:Costs and Cost Analysis; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000191:economics*; D006801:Humans; D007348:Insurance, Health / Q000191:economics*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects