To compare the cost effectiveness of bone marrow transplantation and conventional chemotherapy, we evaluated the resources used in the care of adult patients with acute nonlymphocytic leukemia who were enrolled in a prospective trial and received induction chemotherapy at a single university hospital. Nineteen patients were subsequently treated with chemotherapy and 17 with transplantation. Cost accounting began with induction chemotherapy and extended over a five-year period. Costs were estimated by means of a resource-based, multivariate prediction model. The transplantation and chemotherapy groups had virtually equivalent use of resources (hospital days, laboratory tests, blood products, and radiologic and operative procedures) over five years, except for a 10-fold increase in the use of the intensive care unit for the patients who underwent transplantation (P less than 0.001). The total costs over five years were estimated at $193,000 per patient for transplantation and $136,000 per patient for chemotherapy (P = 0.02). At five years, the costs per year of life saved ("life-year") were nearly equal ($62,500 per life-year for transplantation vs. $64,000 per life-year for chemotherapy) because of the better rate of disease-free survival in patients who underwent bone marrow transplantation. We conclude that the cost effectiveness of bone marrow transplantation to treat acute nonlymphocytic leukemia compares favorably with that of chemotherapy and could be further enhanced if intensive care resources were used more selectively.
Source Information
Department of Medicine, University of Washington, Seattle 98195.
This article has been cited by other articles:
Yu, Y-B, Gau, J-P, You, J-Y, Chern, H-H, Chau, W-K, Tzeng, C-H, Ho, C-H, Hsu, H-C
(2007). Cost-effectiveness of postremission intensive therapy in patients with acute leukemia. Ann Oncol
18: 529-534
[Abstract][Full Text]
Daoud, Y., Amin, K. G, Mohan, K., Ahmed, A R.
(2005). Cost of Intravenous Immunoglobulin Therapy Versus Conventional Immunosuppressive Therapy in Patients with Mucous Membrane Pemphigoid: A Preliminary Study. The Annals of Pharmacotherapy
39: 2003-2008
[Abstract][Full Text]
Lee, S. J., Klar, N., Weeks, J. C., Antin, J. H.
(2000). Predicting Costs of Stem-Cell Transplantation. JCO
18: 64-64
[Abstract][Full Text]
Lee, S. J., Anasetti, C., Kuntz, K. M., Patten, J., Antin, J. H., Weeks, J. C.
(1998). The Costs and Cost-Effectiveness of Unrelated Donor Bone Marrow Transplantation for Chronic Phase Chronic Myelogenous Leukemia. Blood
92: 4047-4052
[Abstract][Full Text]
Scharfstein, J. A., Paltiel, A. D., Freedberg, K. A.
(1997). The Cost-Effectiveness of Fluconazole Prophylaxis against Primary Systemic Fungal Infections in AIDS Patients. Med Decis Making
17: 373-381
[Abstract]
Bates, D. W., Spell, N., Cullen, D. J., Burdick, E., Laird, N., Petersen, L. A., Small, S. D., Sweitzer, B. J., Leape, L. L.
(1997). The Costs of Adverse Drug Events in Hospitalized Patients. JAMA
277: 307-311
[Abstract]
Downs, S. M., Klein, J. D.
(1995). Clinical Preventive Services Efficacy and Adolescents' Risky Behaviors. Arch Pediatr Adolesc Med
149: 374-379
[Abstract]
Wachter, R. M., Luce, J. M., Safrin, S., Berrios, D. C., Charlebois, E., Scitovsky, A. A.
(1995). Cost and Outcome of Intensive Care for Patients With AIDS, Pneumocystis carinii Pneumonia, and Severe Respiratory Failure. JAMA
273: 230-235
[Abstract]
Olivieri, N. F., Nathan, D. G., MacMillan, J. H., Wayne, A. S., Liu, P. P., McGee, A., Martin, M., Koren, G., Cohen, A. R.
(1994). Survival in Medically Treated Patients with Homozygous {beta}-Thalassemia. NEJM
331: 574-578
[Abstract][Full Text]
Murphy, D. J., Povar, G. J., Pawlson, L. G.
(1994). Setting Limits in Clinical Medicine. Arch Intern Med
154: 505-512
[Abstract]
Schapira, D. V., Studnicki, J., Bradham, D. D., Wolff, P., Jarrett, A.
(1993). Intensive Care, Survival, and Expense of Treating Critically III Cancer Patients. JAMA
269: 783-786
[Abstract]
Richardson, G. E., Venzon, D. J., Phelps, R., Edison, M., Brown, M., Frame, J. N., Ihde, D. C., Johnson, B. E.
(1993). Application of an Algorithm for Staging Small-cell Lung Cancer Can Save One Third of the Initial Evaluation Costs. Arch Intern Med
153: 329-337
[Abstract]
Gulati, S. C., Bennett, C. L.
(1992). Granulocyte-Macrophage Colony-Stimulating Factor (GM-CSF) as Adjunct Therapy in Relapsed Hodgkin Disease. ANN INTERN MED
116: 177-182
[Abstract]
Detsky, A. S., Naglie, I. G.
(1990). A Clinician's Guide to Cost-Effectiveness Analysis. ANN INTERN MED
113: 147-154
[Abstract]
Previous
