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[The role of cost analysis in the evaluation of the development of medical technology. The case of allogenic stem-cell transplantation].
- Source :
-
Nederlands tijdschrift voor geneeskunde [Ned Tijdschr Geneeskd] 2004 Mar 06; Vol. 148 (10), pp. 480-4. - Publication Year :
- 2004
-
Abstract
- Objective: To estimate the real costs of allogeneic haematopoetic stem-cell transplantation and to compare these with the historically determined budgets that are made available for this purpose ([symbol: see text] 70,038 for genetically related donors and [symbol: see text] 76,826 for unrelated donors).<br />Design: Cost analysis.<br />Methods: In the period 1994-1999, the direct medical costs (price level of 1998) of bone-marrow transplantation from related donors (BMT), stem-cell transplantation from unrelated donors (VUD-SCT) and allogeneic peripheral-blood stem-cell transplantation (PBSCT) from related donors were determined on the basis of data on adult patients with either acute myeloid leukaemia (n = 66) or acute lymphocytic leukaemia (n = 31). First, the medical resource use by these patients was determined and multiplied by the unit costs of each of the items. Second, a structural programme for allogeneic stem-cell transplantation brings along costs that are not evident from the registration of the medical resource use (e.g., the costs of pretransplantation screening and the selection of the donor). The costs of these items were calculated by taking inventory in the hospitals and assessed by experts.<br />Results: The average costs per transplanted patient were [symbol: see text] 98,334 (BMT), [symbol: see text] 151,754 (VUD-SCT) and [symbol: see text] 98,977 (PBSCT) during the first two years after transplantation. The greater part of the costs was incurred in the transplantation phase. In VUD-SCT, one-third of the total cost was due to the costs of finding a suitable donor.<br />Conclusion: The current budget for allogeneic stem-cell transplantation is insufficient to perform the transplantations adequately. Periodic evaluation of the budgets for complicated procedures based on cost analyses has added value for the evaluation of the development of these procedures in time and can thereby contribute to the quality and continuity of care.
- Subjects :
- Adolescent
Adult
Bone Marrow Transplantation economics
Cost-Benefit Analysis
Female
Hematopoietic Stem Cell Transplantation economics
Humans
Leukemia, Myeloid, Acute economics
Male
Middle Aged
Precursor Cell Lymphoblastic Leukemia-Lymphoma economics
Tissue and Organ Procurement economics
Transplantation, Autologous economics
Transplantation, Homologous economics
Leukemia, Myeloid, Acute therapy
Precursor Cell Lymphoblastic Leukemia-Lymphoma therapy
Stem Cell Transplantation economics
Subjects
Details
- Language :
- Dutch; Flemish
- ISSN :
- 0028-2162
- Volume :
- 148
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Nederlands tijdschrift voor geneeskunde
- Publication Type :
- Academic Journal
- Accession number :
- 15042895