Ανάλυση κόστους αυτόλογης μεταμόσχευσης από αρχέγονα αιμοποιητικά κύτταρα στην Ελλάδα
Cost analysis of autologous peripheral blood stem cell transplantation in Greece
Θανοπούλου, Ειρήνη Δ.
High-dose therapy with autologous stem cell transplantation (ASCT) is now routinely used for patients with relapsed Hodgkin (HL) and non-Hodgkin's (NHL) lymphomas, as well as multiple myeloma (MM). To date there are no available published data regarding cost analysis of A SCT in Greece. Λ retrospective cost analysis of all phases of ASCT for HI.. NHL and MM is performed in the present study, including 4 phases: mobilization, PBSC collection and cryoperservation, pretransplant testing and high-dose therapy plus ASCT until hospital discharge. Twenty-four patients, hospitalized in the Transplantation Unit of the 1st Department of Internal Medicine, National and Kapodistrian University of Athens during 2005 were retrospectively studied from chart viewing. The median total cost per patient for all phases of ASCT was 14.722,65 E for MM, 20.788,79 E' for HL and 26318,00 € for NHL. The cost for MM was significantly lower compared to HL and NHL (p<0.001). From the 4 phases’ analysis, it was shown that the cost difference was significantly different for the mobilization and the high-dose therapy plus ASCT phase. These differences derive from the significantly different cost of chemotherapeutic agents in each disease and from the significantly different consumption of resources, depending on the days of hospitalization. The mean length of hospital stay for the high-dose therapy phase was significantly longer in the lymphomas compared to MM. In addition there was a significant correlation between the length of hospital stay and the cost of high-dose therapy for the lymphomas, not proven for MM. To dale globally, there are no distinct Disease Related Groups (DRGs) for the allogeneic and autologous stem cell transplantation, neither distinct DRG per disease. The results indicate that there is a need for splitting DRG 481 (DRG for stem cell transplantation) into different groups, since significant cost differences exist between the most common diseases for which ASCT is applied. The recognition of these differences will minimize disproportionate charges for Hospital budgets or National Health Systems.