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QoL and Patients' Care

Financial impact of allogeneic hematopoietic cell transplantation on patients and families over 2 years: results from a multicenter pilot study

Bone Marrow Transplantation volume 51, pages 1233–1240 (2016)Cite this article

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Abstract

Hematopoietic cell transplantation (HCT) is a procedure that can significantly influence the socioeconomic wellbeing of patients, caregivers and their families. Among 30 allogeneic HCT recipients and their caregivers enrolled on a pilot study evaluating the feasibility of studying financial impact of HCT, 16 agreed to participate in the long-term phase, completed a baseline questionnaire and received phone interviews at 6, 12, 18 and 24 months post HCT. Analyses showed that by 2 years post HCT, 54% of patients who previously contributed to household earnings had not returned to work and 80% of patients/caregivers reported transplant as having moderate to great impact on household income. However, patients’ levels of confidence in their abilities to meet household financial obligations increased from baseline to 2 years. A relatively large proportion of patients reported inability to pay for medical care through this time period. Case studies demonstrated that patients' individual perceptions of the financial impact of HCT varies considerably, regardless of actual income. We demonstrate the feasibility of conducting a study to evaluate the financial impact of allogeneic HCT through 2 years post transplantation. Some patients/caregivers continue to experience a significant long-term financial burden after this procedure. Our study lays the foundation for a larger evaluation of patient/caregiver financial burden associated with HCT.

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Acknowledgements

We would like to thank Tammy Payton and Lih-Men Mau, PhD, MPH, National Marrow Donor Program (NMDP)/Be The Match, Patient and Health Professional Services department for assisting with the analysis of qualitative data. We thank the study coordinators at the Medical College of Wisconsin (Leigh Ann Laczkowski), Roswell Park Cancer Institute (Dana Cipolla, Lise Hernandez) and the University of Minnesota (Jenna Johnson) for their help in enrolling patients on the study. The NMDP provided funding for study participant honoraria. The CIBMTR is supported by Public Health Service Grant/Cooperative Agreement U24‐CA76518 from the National Cancer Institute (NCI), the National Heart, Lung and Blood Institute (NHLBI) and the National Institute of Allergy and Infectious Diseases (NIAID); a Grant/Cooperative Agreement 5U01HL069294 from NHLBI and NCI; a contract HHSH234200637015C with Health Resources and Services Administration (HRSA/DHHS); two Grants N00014‐06‐1‐0704 and N00014‐08‐1‐0058 from the Office of Naval Research; and grants from Allos, Inc.; Amgen, Inc.; Angioblast; Anonymous donation to the Medical College of Wisconsin; Ariad; Be the Match Foundation; Blue Cross and Blue Shield Association; Buchanan Family Foundation; CaridianBCT; Celgene Corporation; CellGenix, GmbH; Children’s Leukemia Research Association; Fresenius‐Biotech North America, Inc.; Gamida Cell Teva Joint Venture Ltd.; Genentech, Inc.; Genzyme Corporation; GlaxoSmithKline; HistoGenetics, Inc.; Kiadis Pharma; The Leukemia & Lymphoma Society; The Medical College of Wisconsin; Merck & Co, Inc.; Millennium: The Takeda Oncology Co.; Milliman USA, Inc.; Miltenyi Biotec, Inc.; National Marrow Donor Program; Optum Healthcare Solutions, Inc.; Osiris Therapeutics, Inc.; Otsuka America Pharmaceutical, Inc.; RemedyMD; Sanofi; Seattle Genetics; Sigma‐Tau Pharmaceuticals; Soligenix, Inc.; StemCyte, A Global Cord Blood Therapeutics Co.; Stemsoft Software, Inc.; Swedish Orphan Biovitrum; Tarix Pharmaceuticals; Teva Neuroscience, Inc.; THERAKOS, Inc.; and Wellpoint, Inc. The views expressed in this article do not reflect the official policy or position of the National Institute of Health, the Department of the Navy, the Department of Defense, or any other agency of the US Government.

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Authors and Affiliations

  1. National Marrow Donor Program,, Minneapolis,, MN, USA

    E M Denzen, H James, E Murphy & K Pederson

  2. School of Public Health, University of Minnesota,, Minneapolis,, MN, USA

    V Thao

  3. Blood and Marrow Transplantation Program, Roswell Park Cancer Institute,, Buffalo,, NY, USA

    T Hahn & P L McCarthy

  4. Fred Hutchinson Cancer Research Center,, Seattle,, WA, USA

    S J Lee

  5. Center for International Blood and Marrow Transplant Research,, Milwaukee,, WI, USA

    J D Rizzo

  6. Center for International Blood and Marrow Transplant Research,, Minneapolis,, MN, USA

    M Ammi, R Drexler & S Flesch

  7. Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic,, Rochester,, MN, USA

    N Omondi

  8. Blood and Marrow Transplant Program, Cleveland Clinic,, Cleveland,, OH, USA

    N S Majhail

Authors
  1. E M Denzen
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  2. V Thao
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  3. T Hahn
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  4. S J Lee
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  5. P L McCarthy
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  6. J D Rizzo
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  7. M Ammi
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  8. R Drexler
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  9. S Flesch
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  10. H James
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  11. N Omondi
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  12. E Murphy
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  13. K Pederson
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  14. N S Majhail
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Corresponding author

Correspondence to N S Majhail.

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The authors declare no conflict of interest.

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Denzen, E., Thao, V., Hahn, T. et al. Financial impact of allogeneic hematopoietic cell transplantation on patients and families over 2 years: results from a multicenter pilot study. Bone Marrow Transplant 51, 1233–1240 (2016). https://doi.org/10.1038/bmt.2016.103

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