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  1. Significant reduction of medical costs by differentiation therapy with all-trans retinoic acid during remission induction of newly diagnosed patients with acute promyelocytic leukemia.

    Article - En anglais

    Background

    Differentiation therapy with all-trans retinoic acid (RA) induces more than 80% complete remission with the least complications in patients with acute promyelocytic leukemia (APL).

    The authors studied the cost-benefit of this new treatment modality compared with conventional chemotherapy in newly diagnosed patients with APL.

    Methods

    Costs were calculated retrospectively through the monthly bills of each patient to national health insurance and were compared between 36 patients treated with conventional chemotherapy in the AML-87 or AML-89 studies and 40 patients treated with all-trans RA alone or with all-trans RA plus low dose chemotherapy in the AML-92 study of the Japan Adult Leukemia Study Group who were treated at 22 university and cancer hospitals in Japan.

    Results

    Average medical costs except for antileukemic drugs during 2 months after admission were Y4,164,026 in the chemotherapy group and Y2,906,825 in the all-trans RA group (P<0.0001).

    The difference resulted mainly from the costs of antibiotics and of platelet and erythrocyte transfusions.

    Average costs of antibiotics were Y650,494 (approximately US$7,200) and Y349,138 (approximately US$3,900), respectively (P=0.0002), and those of platelet and erythrocyte transfusions were Y1,016,190 (approximately US$11,300) and Y633,444 (approximately US$7,000), respectively (P=0.0020).

    Conclusion

    During the remission induction therapy of newly diagnosed APL, all-trans RA significantly reduced medical costs.

    Mots-clés Pascal : Leucémie promyélocytaire, Homme, Rétinoïque acide, Stéréoisomère tout-trans, Chimiothérapie, Traitement, Analyse avantage coût, Economie santé, Aigu, Hémopathie maligne

    Mots-clés Pascal anglais : Promyelocytic leukemia, Human, Retinoic acid, All trans stereoisomer, Chemotherapy, Treatment, Cost benefit analysis, Health economy, Acute, Malignant hemopathy

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 95-0477564

    Code Inist : 002B02R02. Création : 01/03/1996.