Economic aspects of high-dose chemotherapy: a clinician's perspective review

Abstract

Over the last 15 years, the increased use of high-dose chemotherapy (HDC) has led to a considerable increase in the cost of cancer treatments. After making a general economic analysis of the benefits and costs of healthcare initiatives, this paper considers all of the different phases and elements of HDC, as well as the strategies for reducing basic, indirect and out-of-pocket costs. The cost of HDC has decreased by 40-60% over the last decade and its cost-effectiveness ratios are now similar or only slightly higher than those of other widely accepted medical interventions. However, except in the case of some hematological and paediatric neoplasms, the efficacy of the treatment has not yet been clearly defined and so it should only be used in well-designed clinical trials that should also include prospective cost evaluation measures.