The costs and cost-effectiveness of unrelated donor bone marrow transplantation for chronic phase chronic myelogenous leukemia

摘要: Unrelated donor transplantation prolongs survival in some patients with chronic myelogenous leukemia (CML) phase. However, there are growing concerns about the intensive resources required for this procedure given health care budget constraints. To address issue, we conducted a study of costs and cost-effectiveness unrelated phase CML. The were derived from 157 Brigham Women’s Hospital (BWH) Fred Hutchinson Cancer Research Center (FHCRC). Estimates effectiveness taken our previous work using data International Bone Marrow Transplant Registry National Donor Program. median cost first 6 months including identification, marrow collection, patient hospitalization all outpatient medications readmissions through postmarrow infusion was $178,500 (range, $85,000 to $462,400) mean $196,200. Mean surviving beyond posttransplant significantly lower than dying within that period ($189,700 v $211,000, respectively, P  = .03). Posttransplant follow-up high 18, then decreased. incremental 1 year diagnosis versus -interferon therapy without transplant base case 35-year-old $51,800/quality-adjusted life (QALY) gained. Sensitivity analysis showed most ratios between $50,000 $100,000/QALY or intermediate zone acceptable ratios.