Abstract
Hematopoietic cells transplants are technically complex and expensive imposing a huge burden on health care systems, especially those in developing countries and regions. In 2017 > 4500 transplants were done in 13 Latin American countries with established transplant programmes. We interrogated data on transplant rate, cost, funding source, hospital type, Gini coefficient and the United Nations Development Programme Inequality-Adjusted Human Development Index to determine co-variates associated with transplant development. Transplant rates varied almost 30-fold between the 13 countries from 345 in Uruguay to 12 in Venezuela with a regional transplant rate 7–8-fold lower compared with the US and EU. We found significant correlations between higher transplant cost, public funding, transplants in private hospitals with transplant rate. Low cost per transplant regardless of payor and transplants done in public hospitals were associated with low transplant rates. In contrast, high cost per transplant funded by the government and transplants done in private hospitals were associated with high transplant rates. Surprisingly, we found transplant rates were higher when transplants cost more, when they were done in private for-profit hospitals and payed for with public funds. These data give insights how to increase transplant rates in Latin America and other developing regions.
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Acknowledgements
Hellen Baldomero (WBMT) shared unpublished data. Profs. Navneet Majhail (Cleveland Clinic) and Marcelo Pasquini (CIBMTR) kindly reviewed the typescript. RPG acknowledges support from the National Institute of Health Research (NIHR) Biomedical Research Centre funding scheme. An overview of the conclusions of this study but not the supporting data was previously published.
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RPG is a Consultant to BeiGene Ltd., CStone Pharmaceuticals and Kite Pharmma; a Consultant toFusion Pharma LLC, LaJolla NanoMedical Inc. and Mingsight Parmaceuticals Inc.; an Advisory Board member for Antegene Biotech LLC and StemRad Ltd; Medical Director at FFF Enterprises Inc; Partner in AZACA Inc; and a member of the Board of Directorsof the Russian Foundation for Cancer Research Support.
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Jaimovich, G., Gale, R.P., Hanesman, I. et al. The paradox of haematopoietic cell transplant in Latin America. Bone Marrow Transplant 56, 2382–2388 (2021). https://doi.org/10.1038/s41409-021-01321-x
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DOI: https://doi.org/10.1038/s41409-021-01321-x
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