Costs associated with adverse events from remission induction for children with Acute Lymphoblastic Leukemia (ALL)

BMC Health Services Research

Research

Silvia Martínez-Valverde¹  Yosef Olaf Hernández-Olivares¹  Alfonso Reyes-López¹  Luis Enrique Juárez-Villegas²  Gabriela Hernández-Pliego²  Alberto Daniel Saucedo-Campos²  Juan Garduño-Espinosa³  Leticia A. Barajas-Nava⁴  Eréndira Mejía-Aranguré⁵ 

[1] Centro de Estudios Económicos y Sociales en Salud, Hospital Infantil de México Federico Gómez, Ciudad de México, México;Departamento de Oncología Pediátrica, Hospital Infantil de México Federico Gómez, Ciudad de México, México;Dirección de Investigación, Hospital Infantil de México Federico Gómez, Ciudad de México, México;Medicina Basada en Evidencia, Unidad de Investigación, Hospital Infantil de México Federico Gómez, Ciudad de México, México;Programa de Maestría y Doctorado en Ciencias Médicas, Odontológicas Y de La Salud, Universidad Nacional Autónoma de México, Ciudad de México, México;Medicina Basada en Evidencia, Unidad de Investigación, Hospital Infantil de México Federico Gómez, Ciudad de México, México;Dr. Márquez 162, Col. Doctores. Del. Cuauhtémoc, C.P. 06720, Ciudad de México, México;

关键词: Children;    Cost;    Adverse event;    Leukemia;    Chemotherapy;    Toxicity;    Remission;   

DOI  :  10.1186/s12913-022-08676-x

 received in 2022-02-02, accepted in 2022-10-10,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundALL is the most frequent hematological tumor in children, so during remission induction chemotherapy protocol (RICP) adverse events (AEs) may appear. The public program in Mexico in charge of financial support to oncologic children without social security delivered a fix amount for ALL chemotherapy, but additional money needed to treat any other unexpected condition should be taken from the budget of the oncologic healthcare providers. So the purpose of our study was to estimate and evaluate the direct medical costs associated to EAs during RICP in children with ALL.MethodsThis study was retrospective, longitudinal, and observational based on medical records review of patients in RICP. The CTCAE was used to identify and classify AEs according to a SOC category. We focused on extracting resources data that were consumed both for inpatients and outpatients AEs. A micro-costing approach was adopted which involve quantification of each healthcare resource consumed by the hospital multiplying them by unit cost. The probability distributions of data were evaluated to identify the appropriated statistical tests to be used for comparisons between groups that were performed with Wilcoxon rank sum test. Generalized linear models (GLM) were adjusted to evaluate the effects of patient characteristics on total cost.ResultsForty patients accumulated 204 inpatient and 81 outpatient AEs during RICP. Comparison of total costs between groups showed an incremental cost of $7,460.23 likewise attributable to AEs. The total cost of a pediatric patient undergoing RICP without adverse events was $3,078.36 and the total cost of a patient with AEs exceeds it threefold.ConclusionsThe costs associated with AEs during RICP in Mexican children with ALL representing a high burden for the healthcare provider. Generalized linear models showed that variables such as sex, risk category and alive status are associated with the total costs of AEs. This is the first study aiming to analyze the effect of ALL-related AEs on health care costs in pediatric population, so our results may help not only to local decision making but also it may contribute to the research agenda in this field.

【 授权许可】

CC BY   
© The Author(s) 2022

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