To provide an evidence-based approach to the formulation of clinical policy with respect to allogeneic bone marrow transplantation (BMT) that involves perceived trade offs between two major factors : costs and consequences.
The report also highlights key informational deficiencies.
Adults with acute myeloid leukemia (AML) in second complete remission (2CR) and those with acute lymphoblastic leukemia (ALL) in first complete remission (1CR) were assigned to BMT or control groups solely on the availability of a suitable donor.
All hospital-borne costs were estimated, based on services used according to manual chart review, in four categories : diagnostic and therapeutic costs, professional fees, drug costs, and ward costs.
Incremental costs and incremental life-years were calculated, and the quotient determined a cost per life-year gained by BMT for AML (2CR) and ALL (1CR).
The incremental cost (in 1992 Canadian dollars) per life-year gained by BMT (cost-effectveness) for AML (2CR) was $29,200 ; and for ALL (1CR) it was minus $29,200.
For AML (2CR), allogeneic BMT creates better outcomes than standard treatment, but is more costly.
For ALL (1CR), both the costs and outcomes are similar for BMT and standard therapy.
Quality adjustments made to life-years gained did not change these conclusions.
Mots-clés Pascal : Leucémie myéloblastique, Leucémie lymphoblastique, Adulte, Homme, Homogreffe, Cellule hématopoïétique, Traitement, Analyse coût efficacité, Economie santé, Aigu, Moelle osseuse, Hémopathie maligne, Lymphoprolifératif syndrome, Greffe, Transfusion
Mots-clés Pascal anglais : Acute myelocytic leukemia, Acute lymphocytic leukemia, Adult, Human, Homograft, Hematopoietic cell, Treatment, Cost efficiency analysis, Health economy, Acute, Bone marrow, Malignant hemopathy, Lymphoproliferative syndrome, Graft, Transfusion
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0255382
Code Inist : 002B27D02. Création : 199608.