[Economic cost of peripheral blood progenitor cell transplantation in Spain]

Peripheral blood hematopoietic progenitor cell transplantation (PCT), both autologous and allogeneic, has been consolidated in the last decades as an important tool in the treatment of a number of oncohematologic malignancies. Nevertheless, there are scarce data about the real cost of the autologous procedure in our setting, and to date the economic impact of allogeneic PCT in our health system is unknown.

In the present study a comparative analysis of the economic cost of both methods of PCT was carried out in a series of 67 consecutive patients who were eligible for autologous PCT (n = 48), or allogeneic PCT (n = 19) in a 2 year study period. The expenses derived from pretransplant studies, from the collection and processing of hematopoietic progenitors, and from the transplantation procedure itself were evaluated.

The collection of hematopoietic progenitors was significantly more expensive in autologous than in allogeneic PCT (p = 0.0001), owing both to the difficulty in the mobilization of such cells in patients who have been treated for the underlying disease and to the higher costs derived from the criopreservation of the collected material. Nevertheless, the costs of the pretransplant studies were significantly higher in allogeneic PCT due to the expenses of histocompatibility studies (p = 0.0001). Similarly, the costs derived from the transplantation procedure itself were significantly higher in allogeneic procedures (p = 0.0002) as those patients required a longer hospitalization, and also because of the higher number of patients requiring conditioning regimens including total body irradiation.

From these data we conclude that the real cost of PCT in our setting is 24,000 Euros for the autologous procedure, while it is 34,000 Euros in the context of allogeneic transplantation.