Socio-economic burden of chronic graft-versus-host disease after allogenic bone marrow transplantation

Abstract

Aim. Chronic graft-versus-host disease (crGVHD) socio-economic burden assessment in the Russian Federation.Materials and methods. The assessment was performed in children aged 12–18 years and adults aged over 18 years. The payer's position is "Government". The modeling horizon is 5 years. Direct medical (costs of crGVHD drug therapy; prevention of complications of crGVHD therapy and their treatment in case of occurrence) are taken into account; the cost of visits with the symptoms of crGVHD), as well as direct non-medical costs and indirect costs due to the patient’s disability or disability of their relatives.Results. The total costs for the population of patients with crGVHD aged 12–18 years ranged from 498,120,490 rubles to 1,487,918,739 rubles, in adults — from 969,019,644 rubles to 3,290,898,722 rubles from a five-year perspective, depending on the simulated population size and the choice of the 3rd line therapy regimen. A one-sided sensitivity analysis demonstrated that the main changes in the size of the overall economic burden were observed in the case of changes in the size of the target population, as well as in the cost of therapy.Conclusions. The conducted clinical and economic analyses demonstrated that significant losses of both the health system and the state as a whole were associated with crGVHD after allogeneic bone marrow transplantation, which requires the development of new prevention strategies.