Induction-related cost of patients with acute myeloid leukaemia in France.
Fiche publication
Date publication
avril 2011
Auteurs
Membres identifiés du Cancéropôle Est :
Dr LIOURE Bruno, Pr NERICH Virginie, Pr WORONOFF Macha
Tous les auteurs :
Nerich V, Lioure B, Rave M, Recher C, Pigneux A, Witz B, Escoffre-Barbe M, Moles MP, Jourdan E, Cahn JY, Woronoff-Lemsi MC
Lien Pubmed
Résumé
OBJECTIVE: The economic profile of acute myeloid leukaemia (AML) is badly known. The few studies published on this disease are now relatively old and include small numbers of patients. The purpose of this retrospective study was to evaluate the induction-related cost of 500 patients included in the AML 2001 trial, and to determine the explanatory factors of cost. SETTING: "Induction" patient's hospital stay from admission for "induction" to discharge after induction. METHOD: The study was performed from the French Public Health insurance perspective, restrictive to hospital institution costs. The average management of a hospital stay for "induction" was evaluated according to the analytical accounting of Besancon University Teaching Hospital and the French public Diagnosis-Related Group database. Multiple linear regression was used to search for explanatory factors. MAIN OUTCOME MEASURE: Only direct medical costs were included: treatment and hospitalisation. RESULTS: Mean induction-related direct medical cost was estimated at euro41,852 +/- 6,037, with a mean length of hospital stay estimated at 36.2 +/- 10.7 days. After adjustment for age, sex and performance status, only two explanatory factors were found: an additional induction course and salvage course increased induction-related cost by 38% (+/- 4) and 15% (+/- 1) respectively, in comparison to one induction. These explanatory factors were associated with a significant increase in the mean length of hospital stay: 45.8 +/- 11.6 days for 2 inductions and 38.5 +/- 15.5 if the patient had a salvage course, in comparison to 32.9 +/- 7.7 for one induction (P < 10(-)(4)). This result is robust and was confirmed by sensitivity analysis. CONCLUSION: Consideration of economic constraints in health care is now a reality. Only the control of length of hospital stay may lead to a decrease in induction-related cost for patients with AML.
Référence
Int J Clin Pharm. 2011 Apr;33(2):191-9