Cost analysis of the treatment of acute childhood lymphocytic leukaemia according to Nordic protocols

Abstract

Some attempts have been made to reduce the costs incurred in the therapy of leukaemia, but no studies are available regarding costs of the entire treatment in children with acute lymphocytic leukaemia (ALL). We analysed all the direct costs of treatment of 11 children with ALL diagnosed and treated in Kuopio University Hospital. The follow-up continued from diagnosis until the end of treatment for each patient. Patient treatment on the ward lasted for 84-210 d and in the outpatient clinic for 24-66 d, depending on the risk group. From 11-54 of the inpatient days were required for the treatment of infections. Total mean cost of the entire treatment was US $103250 (US $55196-166039) per patient, 53% of which were basic hospital costs and 47% patient-specific costs. Laboratory tests and radiology accounted for 18% of all direct costs and cytostatic drugs for 13%, but blood products accounted for only 4% of the total. Infections were the most important extra cause of costs, accounting for 18% of the mean total costs per patient. The complete treatment of a child with ALL came to a total of US $103250. However, since 80% of children with ALL are long-term survivors, the cost must be regarded as a good investment.

Cost of treatment for children with acute lymphoblastic leukemia in Bangladesh

“…This variation was due to; the age and size of the patient which determined drug dosage, supportive care needs, the cost of episodes of infection and food, lodging and travel costs. This cost was considerably lower than the costs reported from high income countries even if one was to take into account purchasing power parity corrections [4]. Even so the cost to poor families is still prohibitively high.…”

“…In contrast using a Nordic protocol conducted at the Department of Pediatrics in Kuopio University Hospital, Finland. Rahiala et al [4] reported that the average cost of treatment for their 11 patients was 100,000 USD.…”

“…disciplinary teams in specialized hospital units. Cooperation and collaboration at both national and international levels has helped to achieve this success [1][2][3] The costs of such intensive therapy has been calculated at between 100,000-200,000 USD in high income countries (HICs) where health services are free at the point of care, paid by the public sector and /or insurance schemes which cover most but not necessarily all of such costs [4]. Even in HICs there are still significant "out of pocket expenses" incurred by families in many countries, for example in Canada [5,6].…”

Childhood cancer - mainly curable so where next?

“…The most common form of childhood cancer is leukaemia, and although true estimates of financial cost have been made before, the paper recently published in Acta Paediatrica by Raihala and colleagues (2) gives us a detailed breakdown of how much it really costs to treat children on the Nordic protocols. By costing each and every facet of treatment they have come up with a total cost of USD 103,250 per child.…”

Evaluation of the Effects of Different Transfusion Trigger Levels During the Treatment of Childhood Acute Lymphoblastic Leukemia

“…6 The blood products account for 4% of the total costs of ALL treatment per patient. 7 Safety requirements such as leukocyte depletion and irradiation increase the cost and complexity of transfusions.…”