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. 2016 Sep;5(2):63-75.
doi: 10.2217/ijh-2016-0001. Epub 2016 Apr 27.

Five-year direct costs of acute lymphoblastic leukemia pediatric patients undergoing allogeneic stem cell transplant

Richard T Maziarz  1   1 , Annie Guérin  2   2 , Geneviève Gauthier  2   2 , Julie Heroux  2   2 , Maryia Zhdanava  2   2 , Eric Q Wu  3   3 , Simu K Thomas  4   4 , Lei Chen  4   4
Affiliations

Five-year direct costs of acute lymphoblastic leukemia pediatric patients undergoing allogeneic stem cell transplant

Richard T Maziarz et al. Int J Hematol Oncol. 2016 Sep.

Abstract

Aim: To assess the 5-year healthcare resource utilization (HRU) and direct payer costs following allogeneic hematopoietic stem cell transplants (HSCTs) in acute lymphoblastic leukemia pediatric patients using data from two large US administrative databases.

Patients & methods: Among the 209 patients with acute lymphoblastic leukemia, HRU and costs were described over the up to 5 years after the HSCT.

Results: HRU and costs following the HSCTs were substantial. The highest average costs and most intensive HRU were observed within the first year following the HSCTs (49 outpatient visits; 29 laboratory service visits; 68 inpatient days), with a first year cost of US$683,099 and substantial costs over the following years.

Conclusion: HRU and direct costs associated with allogeneic HSCTs are substantial.

Keywords: acute lymphoblastic leukemia; allogeneic stem cell transplantation; direct costs; economic burden; healthcare resource utilization; pediatric patients.

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Conflict of interest statement

Financial & competing interests disclosure Funding for this research was provided by Novartis Pharmaceuticals Corporation. RT Maziarz is an employee of the Oregon Health & Science University who provided and received payment for consultant services to Novartis Pharmaceuticals Corporation. This potential conflict of interest has been reviewed and managed by OHSU. SK Thomas and L Chen are employees of Novartis Pharmaceuticals Corporation and own stock/stock options. G Gauthier, J Heroux, M Zhdanava, A Guérin and EQ Wu are employees of Analysis Group Inc., which has received consultancy fees from Novartis Pharmaceuticals Corporation for this project. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. Writing assistance was utilized in the production of this manuscript. Shelley Batts, an employee of Analysis Group Inc., aided with formatting and editing this manuscript. Analysis Group Inc., has received consultancy fees from Novartis Pharmaceuticals Corporation for this project.

Figures

<b>Figure 1.</b>
Figure 1.. Study design.
A retrospective cross-sectional cohort design was used to examine outcomes in the up to 5 years following HSCT. HSCT: Hematopoietic stem cell transplantation.
<b>Figure 2.</b>
Figure 2.. Sample selection flowchart.
Description of inclusion and exclusion criteria. ALL: Acute lymphoblastic leukemia; HSCT: Hematopoietic stem cell transplant.
<b>Figure 3.</b>
Figure 3.. Healthcare resource utilization.
Description of healthcare resource utilization following the index date. †IP admissions and IP days for the first 100 days and for year 1 include index hospitalization. OP visits and laboratory service visits are mutually exclusive categories. ER: Emergency room; IP: Inpatient; OP: Outpatient. Please see [23] for a synopsis of these data.
<b>Figure 4.</b>
Figure 4.. Average total healthcare costs.
Description of the average total healthcare costs following the index date. †Costs for the first 100 days and year 1 include the index hospitalization costs. Please see [23] for a synopsis of these data.
<b>Figure 5.</b>
Figure 5.. Distribution of total healthcare costs following the index date.
<b>Figure 6.</b>
Figure 6.. Proportion of total healthcare costs accounted by patients with the highest costs – following the index date.
†Costs for the first 100 days and year 1 include the index hospitalization costs.
See this image and copyright information in PMC

References

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    2. • The annual report of the Center for International Blood and Marrow Transplant Research on worldwide practices and general survival outcomes after hematopoietic cell transplantation – contains data on the number of hematopoietic stem cell transplants (HSCT) performed in the USA, describes information related to practices and outcomes post-transplantation.

    1. Oliansky DM, Camitta B, Gaynon P, et al. Role of cytotoxic therapy with hematopoietic stem cell transplantation in the treatment of pediatric acute lymphoblastic leukemia: update of the 2005 evidence-based review. Biol. Blood Marrow Transplant. 2012;18(4):505–522. - PubMed
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