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Comparative treatment costs of risk‐stratified therapy for childhood acute lymphoblastic leukemia in India

BACKGROUND: To evaluate the treatment cost and cost effectiveness of a risk‐stratified therapy to treat pediatric acute lymphoblastic leukemia (ALL) in India. METHODS: The cost of total treatment duration was calculated for a retrospective cohort of ALL children treated at a tertiary care facility....

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Autores principales: Mungle, Tushar, Das, Nandana, Pal, Saikat, Gogoi, Manash Pratim, Das, Parag, Ghara, Niharendu, Ghosh, Debjani, Arora, Ramandeep Singh, Bhakta, Nickhill, Saha, Vaskar, Krishnan, Shekhar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9939102/
https://www.ncbi.nlm.nih.gov/pubmed/36812120
http://dx.doi.org/10.1002/cam4.5140
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author Mungle, Tushar
Das, Nandana
Pal, Saikat
Gogoi, Manash Pratim
Das, Parag
Ghara, Niharendu
Ghosh, Debjani
Arora, Ramandeep Singh
Bhakta, Nickhill
Saha, Vaskar
Krishnan, Shekhar
author_facet Mungle, Tushar
Das, Nandana
Pal, Saikat
Gogoi, Manash Pratim
Das, Parag
Ghara, Niharendu
Ghosh, Debjani
Arora, Ramandeep Singh
Bhakta, Nickhill
Saha, Vaskar
Krishnan, Shekhar
author_sort Mungle, Tushar
collection PubMed
description BACKGROUND: To evaluate the treatment cost and cost effectiveness of a risk‐stratified therapy to treat pediatric acute lymphoblastic leukemia (ALL) in India. METHODS: The cost of total treatment duration was calculated for a retrospective cohort of ALL children treated at a tertiary care facility. Children were risk stratified into standard (SR), intermediate (IR) and high (HR) for B‐cell precursor ALL, and T‐ALL. Cost of therapy was obtained from the hospital electronic billing systems and details of outpatient (OP) and inpatient (IP) from electronic medical records. Cost effectiveness was calculated in disability‐adjusted life years. RESULTS: One hundred and forty five patients, SR (50), IR (36), HR (39), and T‐ALL (20) were analyzed. Median cost of the entire treatment for SR, IR, HR, and T‐ALL was found to be $3900, $5500, $7400, and $8700, respectively, with chemotherapy contributing to 25%–35% of total cost. Out‐patient costs were significantly lower for SR (p < 0.0001). OP costs were higher than in‐patient costs for SR and IR, while in‐patient costs were higher in T‐ALL. Costs for non‐therapy admissions were significantly higher in HR and T‐ALL (p < 0.0001), representing over 50% of costs of in‐patient therapy. HR and T‐ALL also had longer durations of non‐therapy admissions. Based on WHO‐CHOICE guidelines, the risk‐stratified approach was very cost effective for all categories of patients. CONCLUSIONS: Risk‐stratified approach to treat childhood ALL is very cost‐effective for all categories in our setting. The cost for SR and IR patients is significantly reduced through decreased IP admissions for both, chemotherapy and non‐chemotherapy reasons.
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spelling pubmed-99391022023-02-20 Comparative treatment costs of risk‐stratified therapy for childhood acute lymphoblastic leukemia in India Mungle, Tushar Das, Nandana Pal, Saikat Gogoi, Manash Pratim Das, Parag Ghara, Niharendu Ghosh, Debjani Arora, Ramandeep Singh Bhakta, Nickhill Saha, Vaskar Krishnan, Shekhar Cancer Med RESEARCH ARTICLES BACKGROUND: To evaluate the treatment cost and cost effectiveness of a risk‐stratified therapy to treat pediatric acute lymphoblastic leukemia (ALL) in India. METHODS: The cost of total treatment duration was calculated for a retrospective cohort of ALL children treated at a tertiary care facility. Children were risk stratified into standard (SR), intermediate (IR) and high (HR) for B‐cell precursor ALL, and T‐ALL. Cost of therapy was obtained from the hospital electronic billing systems and details of outpatient (OP) and inpatient (IP) from electronic medical records. Cost effectiveness was calculated in disability‐adjusted life years. RESULTS: One hundred and forty five patients, SR (50), IR (36), HR (39), and T‐ALL (20) were analyzed. Median cost of the entire treatment for SR, IR, HR, and T‐ALL was found to be $3900, $5500, $7400, and $8700, respectively, with chemotherapy contributing to 25%–35% of total cost. Out‐patient costs were significantly lower for SR (p < 0.0001). OP costs were higher than in‐patient costs for SR and IR, while in‐patient costs were higher in T‐ALL. Costs for non‐therapy admissions were significantly higher in HR and T‐ALL (p < 0.0001), representing over 50% of costs of in‐patient therapy. HR and T‐ALL also had longer durations of non‐therapy admissions. Based on WHO‐CHOICE guidelines, the risk‐stratified approach was very cost effective for all categories of patients. CONCLUSIONS: Risk‐stratified approach to treat childhood ALL is very cost‐effective for all categories in our setting. The cost for SR and IR patients is significantly reduced through decreased IP admissions for both, chemotherapy and non‐chemotherapy reasons. John Wiley and Sons Inc. 2022-08-15 /pmc/articles/PMC9939102/ /pubmed/36812120 http://dx.doi.org/10.1002/cam4.5140 Text en © 2022 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle RESEARCH ARTICLES
Mungle, Tushar
Das, Nandana
Pal, Saikat
Gogoi, Manash Pratim
Das, Parag
Ghara, Niharendu
Ghosh, Debjani
Arora, Ramandeep Singh
Bhakta, Nickhill
Saha, Vaskar
Krishnan, Shekhar
Comparative treatment costs of risk‐stratified therapy for childhood acute lymphoblastic leukemia in India
title Comparative treatment costs of risk‐stratified therapy for childhood acute lymphoblastic leukemia in India
title_full Comparative treatment costs of risk‐stratified therapy for childhood acute lymphoblastic leukemia in India
title_fullStr Comparative treatment costs of risk‐stratified therapy for childhood acute lymphoblastic leukemia in India
title_full_unstemmed Comparative treatment costs of risk‐stratified therapy for childhood acute lymphoblastic leukemia in India
title_short Comparative treatment costs of risk‐stratified therapy for childhood acute lymphoblastic leukemia in India
title_sort comparative treatment costs of risk‐stratified therapy for childhood acute lymphoblastic leukemia in india
topic RESEARCH ARTICLES
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9939102/
https://www.ncbi.nlm.nih.gov/pubmed/36812120
http://dx.doi.org/10.1002/cam4.5140
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