ECONOMIC-STUDY OF THE COST OF PERIPHERAL-BLOOD STEM-CELL TRANSPLANTATION COMPARED WITH AUTOLOGOUS MARROW TRANSPLANTATION

BACKGROUND: Rescue with progenitor cells (blood or bone marrow) following intensive chemotherapy is used ever more frequently and the results are particularly satisfactory in leukemias and lymphomas. Nonetheless, the real cost of this procedure is not known in Spain, thus the aim of this study. METHODS: The costs of autologous bone marrow transplantation (ABMT) in 10 patients was compared with another group of 10 patients with the same type of tumoral pathology in which autologous transplantation of peripheral blood precursors (APBP) was used. The period studied included from the first intervention related with the transplantation to 30 days post transplantation. RESULTS: The mean total price of ABMT (1,998 +/- 372 thousand pesetas) is similar to that of APBP (1,736 +/- 383). The length of neutropenia was lower in the APBP requiring fewer platelet transfusions but these difference did not reflect in significantly fewer admissions or in a lesser use of antibiotics, The main expense in both procedures was that of pharmacy followed by blood bank expenses in the ABMT and the expenses of obtaining hematopoietic precursors in the APBP. The saving achieved with the APBP in relation with its faster recovery are countered by the greater cost In obtaining the progenitor cells. Some factors (platelet support and days in the Intensive Care Unit) are responsible for the excessive increases in the cost of these procedures. CONCLUSIONS: Although the transfusion requirements are lesser in autologous transplantation of hematopoietic precursors and the speed of hematologic recovery is greater than in autologous bone marrow transplantation, the cost of both procedures is identical.