Direct cost analysis of the second year post-allogeneic hematopoietic stem cell transplantation in the Bone Marrow Transplant Centre of Tunisia. Issue 1 (1st January 2017)

• Record Type: Journal Article
• Authors: Razgallah Khrouf, Myriam; Achour, Leila; Thabti, Asma; Soussi, Mohamed Ali; Abdejelil, Nour; Lazreg, Olfa; Drira, Chema; Zahaf, Aida; Ladab, Saloua; Ben Othman, Tarek
• Is Part Of: Journal of market access & health policy. Volume 5:Issue 1(2017)
• Publication Date: 2017-01-01
• Subjects: Allogeneic stem cell transplantation -- complications -- cost -- pharmacoeconomic; Medical policy -- Periodicals; Medical policy -- Economic aspects -- Periodicals; International trade -- Environmental aspects -- Periodicals; Health Policy -- economics; Technology Assessment, Biomedical; Marketing of Health Services; International trade -- Environmental aspects; Medical policy; Periodicals; Periodicals; Fulltext; Internet Resources; Periodicals; 362.1
• DOI: 10.1080/20016689.2017.1335161
• Languages: English
• ISSNs: 2001-6689

Abstract

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.​​