Direct cost analysis of the second year post-allogeneic hematopoietic stem cell transplantation in the Bone Marrow Transplant Centre of Tunisia

Figures & data

Table 1. Patients’ characteristics and medical conditions.

Characteristic
Patients, n	32
Gender
Male	21 (66)
Female	11 (34)
Age (years), median (range)	27 (5–50)
HSC transplant source
BM	18 (56)
PSC	14 (44)
Diagnosed condition
ALL	9 (28)
AML	9 (28)
CML	3 (9.3)
Fanconi anemia	3 (9.3)
AM	6 (18)
Other (MM, lymphoma)	2 (18)
Risk of disease at transplantation
High	9 (28)
Standard	23 (72)
Death	2 (6.25)
Complications
Chronic GVHD	13 (40.62)
CMV status	3 (9.37)
Relapse	1 (3.12)

Data are shown as n (%) unless otherwise indicated.

HSC, hematopoietic stem cell; BM, bone marrow; PSC, peripheral stem cell; ALL, acute lymphoblastic leukemia; AML, acute myeloid leukemia; CML, chronic myeloid leukemia; AM, aplasia medular; MM, multiple myeloma; GVHD, graft-versus-host disease; CMV, cytomegalovirus.

Table 2. Direct costs ($).

Type of cost	Mean ± SD	(Min–max)	Median
Total direct costs	11,571 ± 20,558	(204–79,443)	2448
Direct costs
Medical (97%)	11,176 ± 17,443	(186–78,012)	2147
Non-medical (3%)	395 ± 468	(17–1243)	208

Table 3. Direct costs ($) in different patient groups.

Risk/type of cost	Mean (min–max)	Median	p
Risk of underlying disease at transplantation
Standard (n = 23)	10,335 (204–79,443)	1809	0.546
High (n = 9)	14,623 (460–43,012)	16,361
Chronic GVHD
Yes (n = 13)	19,532 (1738–79,442)	16,361	0.032
No (n = 19)	6073 (204–39,993)	1642
CMV status
Yes (n = 3)	54,149 (39,993–79,443)	43,012	< 0.001
No (n = 29)	7133 (204–34,614)	2220
Relapse
Yes (n = 1)	39,993	–	0.103
No (n = 31)	10,623	2373
Source of HSC transplant
BM (n = 18)	8568 (392–79,443)	1790	0.288
PSC (n = 14)	15,362 (204–43,012)	17,757

GVHD, graft-versus-host disease; CMV, cytomegalovirus; BM, bone marrow; PSC, peripheral stem cell.

Table 4. Direct medical costs ($): costs of different components.

	Mean ± SD	%
Direct medical costs	11,176 ± 17,443
Medicines	8517 ± 16,848	76.2
Laboratory tests	1542 ± 2657	13.8
Functional explorations	71 ± 146	0.6
Blood products	80 ± 350	0.7
Drug therapeutic monitoring	112 ± 191	1
Hospitalization services	812	7.3
Consultation	42	0.37

Figure 1. Cost analysis of different therapeutic classes in the second year post-allogeneic hematopoietic stem cell transplantation. ATF, antifungals; ATV, antivirals; ATB, antibiotics; IS, immunosuppressants.​​

Table 5. Direct non-medical costs ($).

	Mean ± SD (min–max)	%
Direct non-medical costs	395 ± 468 (17–1243)	100
Cost of transportation of patients and relatives	247 ± 353	65
Cost of services (equipment and home care)	148 ± 386	35