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Cost-effectiveness analysis of haploidentical vs matched unrelated allogeneic hematopoietic stem cells transplantation in patients older than 55 years

Bone Marrow Transplantation volume 53, pages 1096–1104 (2018)Cite this article

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Abstract

Due to limited donor availability, high comorbidities, and cost issues, allogeneic hematopoietic stem cell transplant is not universally accessible. The aim of this study was to conduct a cost-effectiveness analysis of haploidentical vs matched unrelated transplant. This retrospective study included patients with hematological malignancies older than 55 years who underwent haploidentical or matched unrelated transplant between 2011 and 2013 in Marseille. The incremental cost-effectiveness ratio has been calculated using the mean overall survival and the mean transplant costs. Costs were calculated using a micro-costing strategy from the hospital perspective and a time horizon at 2 years. Haploidentical transplant was considered an innovative procedure and matched unrelated transplant as the reference. Probabilistic and sensitivity analyses were performed on the incremental cost-effectiveness ratio. During inclusion, 29 patients underwent haploidentical transplant and 63 matched unrelated transplant. In haploidentical and matched unrelated transplant, the mean overall survival was 19.4 (1.6) months and 15.1 (1.2) months (p = 0.06), respectively, and the mean cost was 98,304 (40,872) € and 151,373 (65,742) € (p < 0.01), respectively. The incremental cost-effectiveness ratio was assessed to −148,485 (−1,265,550; −64,368) € per life year gained. Among older patients suffering from hematological malignancies, haploidentical transplant seemed in our analysis to be cost-effective compared with matched unrelated transplant.

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Acknowledgements

We thank Christian Naït-Akli, Najoua Guelmani, Karolina Griffiths, and Jaïs Troian.

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    Authors and Affiliations

    1. Aix-Marseille Univ, INSERM, IRD, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale (SESSTIM), Marseille, France

      Mathias Debals-Gonthier, Carole Siani, Catherine Faucher, Rajae Touzani & Anne-Gaëlle Le Corroller Soriano

    2. University of Lyon, University Claude Bernard Lyon 1, ISPB, Lyon, France

      Carole Siani

    3. Institut Paoli Calmettes, Transplant and Cellular Therapy Unit, Marseille, France

      Catherine Faucher, Sabine Furst, Raynier Devillier, Samia Harbi, Luca Castagna, Laurence Caymaris & Didier Blaise

    4. Institut Paoli Calmettes, Hematology Department, Marseille, France

      Catherine Faucher, Sabine Furst, Raynier Devillier, Samia Harbi, Luca Castagna, Laurence Caymaris & Didier Blaise

    5. Institut Paoli Calmettes, SESSTIM, Marseille, France

      Rajae Touzani

    6. Institut Paoli Calmettes, Cell Therapy Facility, Marseille, France

      Claude Lemarié-Basset & Christian Chabannon

    7. Inserm CBT-510, Clinical Investigation Center in Biotherapy, Institut Paoli Calmettes, Marseille, France

      Claude Lemarié-Basset & Christian Chabannon

    8. Centre de Recherche en Cancérologie de Marseille (CRCM), Marseille, France

      Christian Chabannon & Didier Blaise

    9. Aix-Marseille Univ, Marseille, France

      Christian Chabannon & Didier Blaise

    10. Transplant Unit, Department of Hemato-oncology, Humanitas Cancer Center, Milano, Italy

      Luca Castagna

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    These authors contributed equally: Didier Blaise, Anne-Gaëlle Le Corroller Soriano.

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    Debals-Gonthier, M., Siani, C., Faucher, C. et al. Cost-effectiveness analysis of haploidentical vs matched unrelated allogeneic hematopoietic stem cells transplantation in patients older than 55 years. Bone Marrow Transplant 53, 1096–1104 (2018). https://doi.org/10.1038/s41409-018-0133-5

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