Costs of diagnosis, treatment, and follow up of patients with acute myeloid leukemia in the Netherlands

The aim of the study was to calculate the costs in various places of acute myeloid leukemia (AML). Patients less than 65 years old, who were treated for newly diagnosed AML were included. The cost analysis distinguished between diagnosis, treatment, follow-up (maximum of 2 years), and treatment of relapse. The treatment period was divided into remission induction and consolidation treatment, harvest of bone marrow (BM) or peripheral blood stem cells, and transplantation. The costs of diagnosis amounted to $3,167 (1995 US$). Remission-induction treatments cost on average $46,387 and harvest of bone marrow or peripheral blood stem cells costs $6,491. The costs of the transplantation varied between $25,531 and $44,087. Costs of follow-up amounted to $4,167. Relapse treatment, mainly consisting of reinduction therapy, costs on average $24,338. The total average weighted costs of AML patients amounted to $104,386. Treating AML patients is very expensive, and major reductions in costs are not expected in the next future. Considering efficacy and effectiveness, it seemed that choices based on costs could be made between several consolidation techniques and between a specific consolidation technique and/or palliative treatment.