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Costs and cost-effectiveness of allogeneic stem cell transplantation in children are predictable

Susanne Matthes-Martin1, Ulrike Pötschger, Ronald Barr

  • 1Department of Pediatrics, St Anna Children's Hospital, Medical University of Vienna, Vienna, Austria. susanne.matthes@stanna.at

Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation
|April 10, 2012
PubMed

Insights

The total cost of pediatric stem cell transplantation (SCT) varies widely, influenced by patient age, disease status, and donor type. Despite high costs, SCT remains cost-effective for life-threatening conditions.

Area of Science:

  • Pediatric Hematology/Oncology
  • Health Economics
  • Transplantation Medicine

Background:

  • Pediatric stem cell transplantation (SCT) is a critical treatment for various life-threatening conditions.
  • Understanding the economic implications of SCT is essential for resource allocation and healthcare policy.
  • Previous cost analyses for pediatric SCT are limited, particularly regarding comprehensive cost-effectiveness evaluations.

Purpose of the Study:

  • To determine the overall costs associated with pediatric stem cell transplantation (SCT), including donor search and first-year post-transplant expenses.
  • To analyze the correlation between SCT costs and patient/transplantation characteristics, as well as a risk score for transplantation-related mortality.
  • To evaluate the cost-effectiveness of pediatric SCT, calculating costs per surviving patient and per life-year gained.

Main Methods:

  • A cohort of 141 pediatric patients undergoing SCT at a single institution was analyzed.
  • Costs were systematically collected, encompassing donor search and the first year post-SCT.
  • Statistical analyses correlated costs with patient demographics, disease status, donor type, and a validated transplantation-related mortality risk score.

Main Results:

  • The median overall cost for pediatric SCT was €136,382, with significant variability (€26,897 to €601,348).
  • Increased costs were associated with older patient age, use of non-matched sibling donors, and advanced disease.
  • Costs strongly correlated with the transplantation-related mortality risk score, rising from €89,550 (score 0) to €274,915 (score 3).
  • Cost-effectiveness decreased with higher risk scores, with costs per survivor ranging from €93,209 to €1,216,348.

Conclusions:

  • Pediatric SCT costs exhibit substantial variation, predictable by patient age, disease, and donor type.
  • The cost-effectiveness of pediatric SCT is within acceptable ranges for severe hemato-oncologic diseases, even for high-risk patients.
  • These findings provide valuable economic data for healthcare providers and policymakers involved in pediatric transplantation.

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