Costs of allogeneic hematopoietic cell transplantation with high-dose regimens
Costs of allogeneic hematopoietic cell transplantation with high-dose regimens
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DOI：
10.1016/j.bbmt.2007.10.010
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发表时间：
2008-02-01
影响因子：
4.3
通讯作者：
Lee, Stephanie J.
中科院分区：
文献类型：
--
作者：
Saito, Akiko M.;Cutler, Corey;Lee, Stephanie J.
为了描述异基因造血细胞移植高剂量方案（HDCT）的成本，我们分析了从2000年开始的4年研究期间315例HDCT接受者的临床信息和成本。进行多变量分析，以确定前和/或后HDCT的因素预测较高的成本在第一年内。100天和1年的总生存率（OS）分别为80%和58%。2004年住院费用和住院天数的中位数为102 574美元，100天住院36天，一年住院费用和住院天数的中位数为128 800美元，39天。早期成本，定义为前100天内的成本，占第一年总成本的84%。住院费用包括94%的早期成本，但只有61%的后期成本定义为10 1天和1年之间发生的费用。在HDCT前因素中，无关供体和晚期疾病风险与费用增加显著相关。当还考虑HDCT后事件时，这些HDCT前因素不再独立预测高成本。相反，HDCT后的严重并发症与更高的成本相关，平均增加总成本20，228美元。如果没有并发症发生，第一年的平均费用为79，222美元。这些结果提供了复杂和简单HDCT程序的成本估计，以及特定移植并发症的管理成本。(c)2008年美国血液和骨髓移植协会。
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.