Acute leukemia in adults: cost effectiveness of treatment

Costs of treating 174 adult patients with acute leukemia were compiled and analyzed over the five-year period 1974 to 1979. The average overall cost per patient was $18,760, and increased over the period of study. Increased total hospital costs were incurred by patients who achieved a favorable response to induction chemotherapy and by those with a diagnosis of acute lymphocytic leukemia (ALL). To assess the impact of successful treatment on hospital expenditures, total months of survival were compared with total hospital costs to determine cost per month of life. Using this analysis, improved survival, favorable response to chemotherapy, and a diagnosis of ALL were associated with significant decreases in cost per month of life. The long-term survivors (alive greater than or equal to 2 years from diagnosis) best demonstrated this effect, with a mean hospital cost per month of survival from diagnosis of $563, which was significantly less than $6,937 for those who achieved a partial remission, $10,703 for those with treatment failure, and $8,240 for those who were untreated. These costs linked to outcome are comparable to those reported in other disorders that require prolonged and intensive hospital care. With the progressive improvement in response rate and in percentage of long-term survivors that is being observed in adults with acute leukemia, these costs should continue to decrease.