Costs and consequences of stem cell transplantation in children

Abstract

Economic evaluation is a comparison of the costs and consequences of alternative healthcare interventions. Consequences are best assessed as utilities; quality-adjusted measures of effectiveness. Although few substantive data are available, it appears that hematopoietic stem cell transplantation is even more cost-effective in children than in adults.

Costs and Cost-Effectiveness of Allogeneic Stem Cell Transplantation in Children Are Predictable

“…Our calculation of cost-effectiveness was based on the assumption that pediatric long-term survivors will have a close to normal life expectancy and close to normal quality of life [9,[18][19][20][21][22]. Median age at SCT was 10 years, which means that an estimated 60 additional life-years per survivor are likely to be gained [3].…”

“…In this context, the costs of allogeneic stem cell transplantation (SCT) have been evaluated by various centers [3][4][5][6][7][8]. SCT is a well-established and potentially curative approach in patients with high-risk or relapsed leukemia, primary immunodeficiencies, and severe aplastic anemia and is considered a resource-intensive therapy [9].…”

Cost Structure and Clinical Outcome of a Stem Cell Transplantation Program in a Developing Country: The Experience in Northeast Mexico

“…This requires that the institution and transplant team implement policies leading to effective cost lowering and cost containment without affecting efficiency to make the intervention affordable for most of the population [3]. The costs of HSCT can be categorized as direct, indirect, or intangible [4]. Direct costs include the "hotel costs" during hospital stays, which include inpatient days, nursery, medical assistance, laboratory exams, monitoring procedures, drugs, mobilization of stem cells, blood products, donor selection (HLA typing), cell recollection (apheresis), quality control (CD341 counting, chimerism studies), consumables, and depreciation of equipment.…”

“…The costs of HSCT can be categorized as direct, indirect, or intangible [4]. Direct costs include the "hotel costs" during hospital stays, which include inpatient days, nursery, medical assistance, laboratory exams, monitoring procedures, drugs, mobilization of stem cells, blood products, donor selection (HLA typing), cell recollection (apheresis), quality control (CD341 counting, chimerism studies), consumables, and depreciation of equipment.…”

“…Direct costs include the "hotel costs" during hospital stays, which include inpatient days, nursery, medical assistance, laboratory exams, monitoring procedures, drugs, mobilization of stem cells, blood products, donor selection (HLA typing), cell recollection (apheresis), quality control (CD341 counting, chimerism studies), consumables, and depreciation of equipment. This categorization should also address the costs to families, a matter of special importance in the pediatric context, as in children with cancer, for whom this cost has been estimated to amount to one third of after-tax family income [4].…”