TY - JOUR
T1 - Costs of Allogeneic Hematopoietic Cell Transplantation with High-Dose Regimens
AU - Saito, Akiko M.
AU - Cutler, Corey
AU - Zahrieh, David
AU - Soiffer, Robert J.
AU - Ho, Vincent T.
AU - Alyea, Edwin P.
AU - Koreth, John
AU - Antin, Joseph H.
AU - Lee, Stephanie J.
N1 - Funding Information:
This study was supported by National Heart, Lung, and Blood Institute grant (# P01 HL070149) and a Marx Fellowship. We thank our colleagues at the DFCI/BWH and our patients for sharing their experiences with us. We also thank Qiheng Yang, Tarrah Kirkpatrick, Daniel J. Quinn, Robin R. Junkins, Denise Sullivan, Benjamin S. Parsons, Celeste Daye, and Mohammed Yousuf for their help in gathering clinical and cost information.
PY - 2008/2
Y1 - 2008/2
N2 - 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 1 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 1 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 101 days and 1 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.
AB - 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 1 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 1 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 101 days and 1 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.
KW - Costs
KW - Hematological malignancies
KW - Hematopoietic cell transplantation with high-dose regimens
KW - Outcomes research
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U2 - 10.1016/j.bbmt.2007.10.010
DO - 10.1016/j.bbmt.2007.10.010
M3 - Article
C2 - 18215780
AN - SCOPUS:38149030822
SN - 1083-8791
VL - 14
SP - 197
EP - 207
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 2
ER -