Abstract
To estimate management costs of chemotherapy and allogeneic stem-cell transplant (allo-SCT) for children and adolescents with acute lymphoblastic leukemia (ALL) in France. Data were extracted from the French national hospitalization database (PMSI) for patients <18 years hospitalized in 2015 and/or 2016. Hospitalizations were selected using ICD-10 diagnosis code for ALL (C91.0). For chemotherapy, all patients with a chemotherapy stay in 2015-2016 were included. For allo-SCT, all patients with at least one allo-SCT stay in 2015-2016 after a previous chemotherapy stay in 2015 were included. For patients who underwent allo-SCT, graft versus host disease (GvHD) stays after the first allo-SCT stay were identified in 2015-2016. Stem cell donation stays were also identified in 2015-2016. All costs were valorized as production costs (ENCC 2014-2015), inflation adjusted (€2017), and studied considering the type of stays (day-care hospitalization vs inpatient) and age groups (<6 ; ≥6 and <12 ; ≥12 and <18 years). Overall, 2,102 children and adolescent patients with ALL were included, of which 42% were <6 years, 37% were ≥6 and <12 years, and 21% were ≥ 12 and < 18 years. Among these patients, a total of 41,597 hospital stays (day-care hospitalization: 85% vs inpatient: 15%) were retrieved. The average management cost of chemotherapy was €1,891/stay (day-care hospitalization: €404 vs inpatient: €10,449). Among the 135 patients who underwent allo-SCT, 94 (70%) developed a GvHD. The average management cost of allo-SCT was €75,972/stay, the average management cost of GVHD was €10,721/stay, and the average cost of stem cell donation was €1,751/stay. Management costs of chemotherapy and allo-SCT for children and adolescents with ALL in France were estimated from the PMSI database, in which type of ALL, stage of the disease and chemotherapy regimens are not available. This lack of clinical data could be addressed with experts.
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