Outpatient high-dose melphalan in multiple myeloma patients. Outpatient ASCT can be an attractive The donor may be a blood relative but can also be someone who is not related. At hospital D, 80% of activity is related to regional and national functions relating to major and costly specialities and procedures, it being the only center of transplantation activity in Norway. The present study investigated All cost data are reported at 2001 prices and have been recalculated into US$ by using the exchange rates of 1st January 2001. Epub 2019 Feb 20. Also, costs did not include patient and caregiver non-medical costs (for example, transportation, lodging, lost income) that are not captured by the MarketScan claims database. Patients were treated at a university hospital outpatient clinic that was open 5 days a week. In the meantime, to ensure continued support, we are displaying the site without styles J Clin Oncol 2000; 18: 64–71. Costs of pediatric allogeneic hematopoietic-cell transplantation. HDT with infusion of autologous stem cells was followed by hospitalization. Gratwohl A, Baldomero H, Passweg J et al. Taken together, staffing, medication and blood products contributed to 74% of total costs. Thirdly, costs related to academic and research functions were not calculated. Stem cell therapy prices usually range from around $5,000 – $50,000. Transplants were more expensive and associated with more hospitalized days in patients aged ⩽20 years. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Cancer 2008; 112: 1096–1105. Autologous hematopoietic stem-cell transplantation for multiple myeloma. An investigational trial in the Nordic countries for myeloma was started in 1995. Overall, the demographic profile of patients from the two databases was similar. In a cohort of 400 patients (median age, 63 years; range, 22 to 79 years), after a median follow-up of 50.4 months, 197 patients had relapsed and 36 had received HPC infusion as salvage autoHCT (n = 29) and/or HPC boost (n = 8). Lee SJ, Joffe S, Artz AS, Champlin RE, Davies SM, Jagasia M et al. Ann Intern Med 1996; 126: 600–607.  |  Major cost variables: overall staff costs, pharmacy costs and blood product costs. J Clin Oncol 2008; 26: 2162–2170. The analysis shows that, due to these differences, there were on average 15% higher overhead costs per patient at hospitals A, B and D than in C, which is a comprehensive cancer center with a staff of 1800. Please enable it to take advantage of the complete set of features! PubMed Central  PubMed Google Scholar. A simplified approach to stem cell mobilization in multiple myeloma patients not previously treated with alkylating agents. http://www.hcup-us.ahrq.gov/reports/statbriefs/sb82.pdf. Direct hospital resource utilization and costs of treating patients with multiple myeloma in southwest Sweden: a 5-year retrospective analysis. Predicting costs of stem-cell transplantation. HPC utilization was significantly higher in the 60- to 64-year age group, whereas no patients who were age ≥70 years at the time of first autoHCT received salvage autoHCT. Many readers sent us their invoices for treatment (with personal details retracted). Allocation of indirect costs was performed through a set of predefined allocation keys, such as the number of patients discharged and length of stay. Total costs were >$500 000 for 20% and 6% of ⩽20 year and >20-year-old patients, respectively. Hematopoietic stem cell transplantation: a global perspective. September 26, Seventy-six patients (84%) were hospitalized Allogeneic transplant physician and center capacity in the United States. Costs were greater among pediatric (⩽20 years) compared with adult (>20 years) recipients and this difference was more pronounced with allogeneic HCT. CAS  Published by Elsevier Inc. All rights reserved. The present study investigated safety and cost-effectiveness of the outpatient program. Clin Lab Haematol 2002; 24: 187–190. The cost savings was $19,522 (Canadian dollars) per patient compared Bone Marrow Transplant 2003; 31: 99–103. Some patients live relatively close to their hospital and may be discharged and rehospitalized for treatment during the aplasia period. for prolonged hospitalization (longer than 7 days) were disease stage IIB or higher In the meantime, to ensure continued support, we are displaying the site without styles Copyright © 2020 Elsevier B.V. or its licensors or contributors. The study showed significant variations for all these elements, which may be due to differences in medical practice and differences in preferences for, and pricing of, pharmaceutical products. A large part of the actual cost in the harvest phase was attributed to stem cell mobilization, including growth factors, harvesting and cryopreservation. We performed a prospective cost analysis of the mobilization, harvesting and cryopreservation phases and the high-dose therapy with stem cell reinfusion and hospitalization phases. Schulman KA, Birch R, Zhen B et al. Blood 1998; 92: 4047–4052. See Table 1 for patient characteristics. Costs are described for the inpatient and outpatient phase of treatment. This site needs JavaScript to work properly. The author reported a remarkably low cost per patient for the stem cell harvesting and cryopreservation procedures, an average of EUR 4982, and a blood component cost (during the induction chemotherapy regimen, harvesting and transplantation phase), respectively, of EUR 904, EUR 376 and EUR 1680, a total of EUR 2960. Using a claims database representing a national HCT population, we highlight the high costs associated with autologous and allogeneic HCT. The Rikshospitalet University Hospital performed the first peripheral blood stem cell transplant (PBSCT) in a patient with acute myeloid leukemia in 1990. Variation in supportive care practices in hematopoietic cell transplantation. Relative contribution of costs of hematopoietic cell transplant hospitalization, costs of any subsequent hospitalization and outpatient costs to total costs of hematopoietic cell transplantation in the first 100 days after transplantation. Rizzo JD, Vogelsang GB, Krumm S, Frink B, Mock V, Bass EB . Biol Blood Marrow Transplant 2008; 14: 197–207. Google Scholar. Overall survival Eur J Cancer 2001; 37: 1781–1789. Their costs incurred were comparable to patients who maintained coverage for all 100 days; median total costs were $99 865 (IQR, $73 914–140, 412; N=1566) for patients enrolled for all 100 days and $100 840 (IQR, $73 459–147 400; N=112) for patients who were disenrolled before day 100 (P=0.51). For malignant lymphoma patients MIME (methyl-GAG, ifosfamide, methotrexate, etoposide) ICE (ifosfamide, carboplatine, etoposide) were used, the latter supported by G-CSF. We also conducted a Twitter poll, which received hundreds of responses. Clinical and economical comparision of lenograstim primed blood cells (BC) and bone marrow (BM) allogenic transplantation. HDT was not included in this reimbursement system as a special procedure although it has been regarded as standard treatment for malignant lymphoma since 1995. Cost of autologous peripheral blood stem cell transplantation: the Norwegian experience from a multicenter cost study. Blood product cost at individual patient level. Bone Marrow Transplant 48, 294–300 (2013). Current status of stem cell mobilization. Lee SJ, Klar N, Weeks JC, Antin JH . Gowper PA, DeLong ER, Peterson ED et al. Like autologous HCT recipients, the majority of medical costs (75%) occurred during the initial transplant hospitalization (Figure 2). (2020), Biology of Blood and Marrow Transplantation Bone Marrow Transplantation and JavaScript. We initiated Before being considered for HDT, myeloma patients were required to have responded to, or not to have disease progression following, 3–4 VAD (vincristine, adriamycin, dexamethasone) courses. They were in relatively good general condition, without severe heart, lung or renal disease or uncontrolled infection. PubMed Central  Ketterer N, Salles G, Raba M et al. Agency for Healthcare Research and Quality: Rockville, MD. Hematopoietic Progenitor Cell Mobilization for Autologous Stem Cell Transplantation in Multiple Myeloma in Contemporary Era. Survival after transplantation was comparable to that in those who underwent transplantation patients under 65 years and significantly longer than older patients who did not undergo transplantation. Copyright © 2020 American Society for Transplantation and Cellular Therapy. The prospective cost analysis approach provides a valuable starting point in understanding the cost and improving the financial efficiency of providing modern care to myeloma and lymphoma patients. A silicone rubber atrial catheter for prolonged parenteral alimentation. Reduced charges and costs associated with outpatient autologous stem cell transplantation. Costs were not adjusted for inflation, given the short time frame considered in this analysis. By continuing you agree to the, https://doi.org/10.1016/j.bbmt.2012.12.006, Safety and Cost-Effectiveness of Outpatient Autologous Stem Cell Transplantation in Patients with Multiple Myeloma, Redistribute or republish the final article, Translate the article (private use only, not for distribution), Reuse portions or extracts from the article in other works, Distribute translations or adaptations of the article. Further, the allogeneic transplant from a related donor costs less than an allogeneic transplant from an unrelated donor. Measuring costs: administrative claims data, clinical trials, and beyond. By continuing you agree to the use of cookies. Patients were identified as HCT recipients, if they had at least one inpatient claim with an International Classification of Diseases Ninth Edition (ICD-9) procedure code for HCT (see Table 1 for codes) between January 2007 and December 2009. Remodeling an infarcted heart: novel hybrid treatment with transmyocardial revascularization and stem cell therapy. Med Care 2009; 47: S51–S55. Erythrocyte transfusions were given if the hemaglobin fell below 8 g/dl and thrombocytes when the platelet count fell below 10 × 109/l. Lee SJ, Astigarraga CC, Eapen M, Artz AS, Davies SM, Champlin R et al. Patient hotel stays have become common practice is Norway, where distance to the patient's home often makes travel difficult. Costs not reflected in the DRG-reimbursement were assumed to be covered by the hospitals' basic grants. We use cookies to help provide and enhance our service and tailor content and ads. These data were divided into the following cost items: (1) hospitalization and basic medical service, including medical and nursing staff; (2) pharmacy and blood products; (3) procedures such as operating theatre, leucapheresis and cryopreservation. Instead, the relevant patients were divided into groups of DRG (DRG 403 lymphoma and nonacute leukemia with complication and DRG 404 lymphoma and nonacute leukemia without complication) that did not take into account the special costs related to the procedure. Several studies have investigated, by standard regression techniques, the influence of various patient demographic variables, clinical factors and treatment on LOS and hospital cost.14, 15, 16, 17 Our study result shows that LOS for the two phases varied from 27 to 37 days (Table 2). Outpatient ASCT can be an attractive option given wait times and costs associated with inpatient procedures. Tarella C, Cuttica A, Vitolo U et al. Hematopoietic stem cell transplantation activity in Europe 1999.

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