Journal
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
Volume 14, Issue 2, Pages 197-207Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.bbmt.2007.10.010
Keywords
costs; outcomes research; hematopoietic cell transplantation with high-dose regimens; hematological malignancies
Categories
Funding
- NHLBI NIH HHS [P01 HL070149-030001, P01 HL070149-020001, P01 HL070149-050001, P01 HL070149-01A1, P01 HL070149-01A10001, P01 HL070149, P01 HL070149-05, P01 HL070149-03, P01 HL070149-02, P01 HL070149-040001, P01 HL070149-04] Funding Source: Medline
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To characterize the costs of allogeneic hematopoietic cell transplantation with high-dose regimens (HDCT), we analyzed clinical information and costs of 315 HDCT recipients during a 4-year study period beginning in 2000. Multivariate analyses were performed to identify pre- and/or post-HDCT factors predicting higher costs within the first year. Overall survival (OS) at 100 days and I year were 80% and 58%, respectively. The median cost and days of hospitalization were $102,574 in 2004 US dollars and 36 days in the hospital for 100 days, and $128,800 and 39 days in the hospital for I year. Early costs, defined as costs within the first 100 days, accounted for 84% of total costs within the first year. Inpatient costs comprise 94% of the early costs, but only 61% of the later costs defined as costs incurred between 10 1 days and I year. Of the pre-HDCT factors, unrelated donors and advanced disease risk were significantly associated with increased cost. When post-HDCT events were also considered, these pre-HDCT factors were no longer independently predictive of high cost. Instead, severe complications post-HDCT were associated with higher costs, increasing total costs $20,228 on average. If no complications occurred, the mean cost within the first year was $79,222. These results provide cost estimates for complicated and uncomplicated HDCT procedures, as well as costs for management of specific transplant complications. (c) 2008 American Society for Blood and Marrow Transplantation.
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