Estimating the Burden of Cost in Chronic Graft-versus-Host Disease: A Human Capital Approach
Chris A Jones1, Luca P Fernandez2, Peter Weimersheimer3
1Department of Surgery Global Health Economics Unit of the Vermont Center for Clinical and Translational Science, Burlington, VT (USA); University of Vermont College of Medicine, Burlington, VT (USA).
Insights
Chronic graft-versus-host disease (cGvHD) after stem cell transplants will cost over $27 billion in lost wages in the next decade. This economic burden from lost productivity significantly outweighs direct treatment costs for cGvHD patients.
Area of Science:
- Hematology
- Transplantation Medicine
- Health Economics
Background:
- Chronic graft-versus-host disease (cGvHD) is a significant cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation (HSCT).
- Advances in acute graft-versus-host disease (aGvHD) management have shifted focus to the long-term impact of cGvHD, which can manifest years post-transplant.
Purpose of the Study:
- To estimate the economic burden of cGvHD in the United States over a ten-year period.
- To quantify the societal cost associated with lost work time and productivity due to cGvHD following HSCT.
Main Methods:
- Utilized published estimates of cGvHD incidence, morbidity, and survivorship.
- Incorporated data on the value of lost work time to calculate economic impact.
- Employed a novel ten-year time horizon for rare disease cost analysis.
Main Results:
- An estimated 44,450 cGvHD patients will require treatment in the U.S. between 2015 and 2025.
- These patients are projected to experience 605,631 years of lost wages.
- The societal cost of lost productivity is estimated at over $27 billion, exceeding treatment costs ($5.2 billion) by more than fivefold.
Conclusions:
- The economic impact of lost productivity from cGvHD is substantial and significantly underestimated.
- Societal costs associated with cGvHD extend far beyond direct medical expenditures.
- Future economic analyses of HSCT complications should incorporate lost work time as a critical factor.
Abstract:
With advances in organ matching and preventing acute graft-versus-host-disease (aGvHD), chronic graft-versus-host disease (cGvHD) following allogeneic hematopoietic stem cell transplantation (HSCT) has become a focus of transplant-related morbidity and mortality. Given that cGvHD often presents years following a transplant, our objective was to estimate its burden of cost resulting from allogeneic HSCT based on published estimates of incidence, morbidity, the value of lost work time and survivorship. Our choice of a ten-year time horizon is novel to the field of rare disease and was determined to be meaningful after consultations with present co-authors, including five physicians, one of whom is a transplant surgeon. A total of 44 450 cGvHD patients in the United States were estimated to require treatment over the next decade (from 2015 to 2025). This estimate is based on the last 5 years of trends reported in the transplant registries. What is not reported in any registry is that these patients will accrue a total of 605 631 years of lost wages, a collective lost productivity that will cost society over $27 Billion in the decade ahead: more than five times ($27B vs. $5.2B) the estimated ten-year cost of treating the condition.
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