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Published on: August 31, 2016
Cost Assessment of Pediatric Haploidentical Hematopoietic Stem Cell Transplantation
Leila Achour1,2, Ikram Fazaa1,2, Chema Drira1,2
1Pharmacy Department, National Bone Morrow Transplant Center, Tunis, Tunisia.
Insights
Pediatric haplo-SCT is more costly than geno-SCT, with higher overall expenses for pediatric patients. This study informs tailored reimbursement for hematopoietic stem cell transplantation (HSCT) in Tunisia.
Area of Science:
- Pharmacoeconomics
- Hematology
- Health Policy
Background:
- Hematopoietic stem cell transplantation (HSCT) is a critical treatment for various pediatric and adult diseases.
- Cost-effectiveness analysis is essential for developing sustainable healthcare reimbursement strategies.
Purpose of the Study:
- To evaluate the costs of pediatric haplo-SCT and adult/pediatric geno-SCT at CNGMO.
- To inform the Tunisian Health Insurance Fund for a tailored reimbursement package.
Main Methods:
- Pharmaco-economic study employing activity-based costing.
- Cost assessment from the hospital's perspective, including direct medical and non-medical costs.
Main Results:
- Pediatric patients incurred higher costs than adult patients.
- Haplo-SCT was more expensive than geno-SCT for pediatric patients.
- Intensive conditioning regimens, longer inpatient stays, and complications (infections, GVHD, CMV reactivation) drive higher costs.
Conclusions:
- Establishes standards for new, specific reimbursement packages for haplo-SCT and geno-SCT in pediatric patients.
- Provides a foundation for equitable and sustainable HSCT funding.
Purpose:
Evaluate the costs related to the pediatric haplo-SCT and adult and pediatric geno-SCT at the CNGMO in order to establish a tailored reimbursement package by the Tunisian Health Insurance Fund.
Patients And Methods:
This pharmaco-economic study compared the cost of pediatric haplo-SCT to adult and pediatric geno identical hematopoietic stem cell transplantation (geno-SCT) using the activity-based costing method. The cost assessment was conducted from the hospital's perspective and considered direct medical and non-medical costs.
Results:
The cost assessment indicated that pediatric patients incurred higher expenses than adult patients. Furthermore, haplo-SCT was more expensive than geno-SCT for pediatric patients. The conditioning regimens used before haplo-SCT are more intensive than other preparative regimens and typically require longer inpatient therefore resulting in more costs. Complications, such as infections during the early phase of neutropenia and late-onset issues following hematopoietic stem cell transplantation (HSCT), particularly graft-versus-host disease (GVHD) and cytomegalovirus (CMV) reactivation, significantly contribute to increased procedural costs.
Conclusion:
This study sets the standards for new specific packages for haplo-SCT and geno-SCT in pediatric patients.
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