¹Institute for Medical Technology Assessment, Department of Health Care Policy and Management, Erasmus University Rotterdam, The Netherlands

²Department of Haematology, University Medical Centre Utrecht, The Netherlands

³Department of Haematology, Erasmus University Medical Centre Rotterdam, The Netherlands

⁴Department of Haematology, University Medical Centre St Radboud, Nijmegen, The Netherlands

⁵Europdonor Foundation, Leiden University Medical Centre, Leiden, The Netherlands

⁶Department of Haematology, Leiden University Medical Centre, Leiden, The Netherlands

Correspondence to: M van Agthoven, Institute for Medical Technology Assessment, Department of Health Care Policy and Management, Erasmus University Rotterdam, PO Box 1738, 3000 DR Rotterdam, The Netherlands

Allogeneic stem cell transplantation (SCT) is one of the most expensive medical procedures. However, only a few studies to date have addressed the costs of HLA-identical sibling transplantation and only one study has reported costs of unrelated transplantation. No recent cost analysis with a proper follow-up period and donor identification expenses is available on related or voluntary matched unrelated donor (MUD) SCT for adult AML or ALL. Therefore, we calculated direct medical (hospital) costs based on 97 adults who underwent HLA-identical sibling bone marrow transplantation (BMT) or peripheral blood stem cell transplantation (PBSCT), and patients who received a graft from a MUD between 1994 and 1999. The average costs per transplanted patient were 98 334 (BMT), 151 754 (MUD), and 98 977 (PBSCT), including donor identification expenses, 2 years follow-up and costs of patients who were not transplanted after they had been planned to receive an allograft. The majority of these costs was generated during the hospitalisation for graft infusion. For MUD transplants, nearly one-third of these costs was spent on the search for a suitable donor. For patients who were alive after 2 years, cumulative expenses were calculated to be 103 509 (BMT), 173 587 (MUD), and 105 906 (PBSCT).

Bone Marrow Transplantation (2002) 30, 243-251. doi:10.1038/sj.bmt.1703641

cost analysis; allogeneic; bone marrow transplantation; stem cell transplantation; acute myeloid leukaemia; acute lymphoblastic leukaemia