THE COST OF ACUTE LYMPHOBLASTIC LEUKEMIA TREATMENT IN CHILDREN USING COMBINED CHEMOTHERAPY AND IMMUNOTHERAPY: COMPARISON OF ESTIMATED AND REAL VALUES

Abstract

Acute lymphoblastic leukemia is the most common pediatric cancer. The effectiveness of modern therapy protocols makes it possible to cure over 80% of children, and one of the advanced treatment methods is the use of monoclonal antibodies. Using the example of adult patients in the United States, the economic effectiveness of this innovative treatment strategy was proven, while no similar studies have been conducted in children with primary acute lymphoblastic leukemia. The aim of the study was to determine the real cost of therapy for children and adolescents with acute lymphoblastic leukemia according to the protocol using combined chemotherapy and immunotherapy at the stages of induction and consolidation. Materials and methods. The study included data from 54 patients (the study group) who received therapy using this method, taking into account indicators of direct medical and non-medical costs. The control group included 54 patient models corresponding to the initial estimated parameters when planning the protocol (body weight 30 kg, body surface area 1 m2). Research results. The median of real cost for providing medical care to one patient in the study group was 22% lower than the estimated cost. In its structure, the values of the median costs for inpatient stay, for instrumental and laboratory studies, as well as for drug therapy turned out to be lower. Since younger patients were included in the study group, the cost of drug therapy was recalculated to the calculated patient model, which equalized the median cost of drug therapy for the study and control groups. In a situation with equal characteristics of patients, as well as with the same cost of a day of inpatient stay, the median real cost of providing medical care to one patient in the study group corresponded to the estimated values. Conclusions. The median cost of medical care for patients with acute lymphoblastic leukemia according to the protocol using combined chemotherapy and immunotherapy in the study group was 22% lower than the estimated values. The actual practice of using the protocol for an average patient model with an equal cost of inpatient stay fully corresponded to the estimated values of the protocol.