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. 2017 Jun 15;5(1):1335161.
doi: 10.1080/20016689.2017.1335161. eCollection 2017.

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

Myriam Razgallah Khrouf  1   2 , Leila Achour  1   2 , Asma Thabti  1   2 , Mohamed Ali Soussi  1   2 , Nour Abdejelil  3   4 , Olfa Lazreg  1 , Chema Drira  1   2 , Aida Zahaf  1 , Saloua Ladab  3   4 , Tarek Ben Othman  3   4
Affiliations

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

Myriam Razgallah Khrouf et al. J Mark Access Health Policy. .

Abstract

Background: Hematopoietic stem cell transplantation (HSCT) is a medically complicated therapy with a long recovery time. In Tunisia, the National Health Insurance Fund (CNAM) covers only the first year post-transplantation, after which the costs are borne by the hospital. Objective: Describe complications that can occur during the second year post-allogeneic HSCT and calculate direct costs in different groups of patients. Methods: In this pharmacoeconomic study, medical records of the second year post-allogeneic HSCT were collected. Studied variables included frequent observed complications and medical and non-medical direct costs. Results: The average total direct cost in the population during the second year post-transplantation was $11,571, 97% of which represents direct medical costs Drugs accounted for the largest share (80%) of total direct costs, dominated by the cost of antifungals (52%) and antivirals (26%) drug . Cytomegalovirus status was seen in 9.3% of patients and was associated with a seven-fold increase in direct costs (p < 0.001).​​In patients who developed chronic GVHD, the average direct cost was three times higher than for those who did not (p = 0.032). Conclusion: Given the importance of direct costs in the post-transplantation period a review of the hospital financing mechanism and a new convention with the CNAM is crucial.​​.

Keywords: Allogeneic stem cell transplantation; complications; cost; pharmacoeconomic.

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Figures

Figure 1.
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.​​
See this image and copyright information in PMC

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