Cost analysis of childhood hematopoietic stem cell transplantation in Sichuan, China

Min Chen; Yantao Liu; Xue Yang; Yu Hong; Jiaqi Ni

doi:10.3389/fpubh.2023.990181

Cost analysis of childhood hematopoietic stem cell transplantation in Sichuan, China

Front Public Health. 2023 Mar 23:11:990181. doi: 10.3389/fpubh.2023.990181. eCollection 2023.

Authors

Min Chen^{1

2

3}, Yantao Liu^{1

2

3}, Xue Yang^{3

4}, Yu Hong⁵, Jiaqi Ni^{1

2

3

5}

Affiliations

¹ Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China.
² Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China.
³ Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China.
⁴ Department of Pediatric Hematology and Oncology, West China Second University Hospital, Sichuan University, Chengdu, China.
⁵ West China School of Pharmacy, Sichuan University, Chengdu, China.

Abstract

Objective: To analyze the inpatient cost of hematopoietic stem cell transplantation (HSCT) in children, so as to support clinical decision-making.

Methods: Study population were children who received HSCT in a tertiary children's hospital (Sichuan, China) between 1st January 2020 and 31st December 2021. The median and interquartile range (IQR) of total cost at 100 days post transplantation were calculated. Subgroup analyses were conducted based on age, gender, transplantation types, and post-transplant complications. The cost differences between subgroups were analyzed to determine whether it had an impact on the total costs.

Results: A total of 142 pediatric patients were included in the study with a total cost of 250721.78 yuan (197019.16-315740.52, 1 yuan equals to around 0.15 US dollars). Drug costs accounted for 51.85% of the total cost, followed by medical service costs (12.57%) and treatment expenses (12.24%). In terms of transplantation types, the cost of autologous transplantation was lower than that of allogeneic transplantation (115722.98 yuan vs. 256043.99 yuan, p < 0.05), and the cost of human leukocyte antigen (HLA) complete matched was lower compared with that of partial matched (213760.88 yuan vs. 294044.84 yuan, p < 0.05). As for post-transplant complications, cases with <3 types of complications cost less than those with ≥3 types (212893.25 yuan vs. 286064.60 yuan, p < 0.05), and those with severity ≤ grade 2 cost less than those > grade 2 (235569.37 yuan vs. 280061.58 yuan, p < 0.05). Age and gender of patients did not lead to statistical differences in the total cost, while the transplantation types and post-transplant complications influenced the total cost.

Conclusion: The total cost at 100 days post transplantation associated with HSCT treatment were substantial for pediatric patients. The HLA compatibility between donors and recipients, and post-transplant complications were important factors affecting the total cost.

Keywords: China; children; cost analysis; developing country; hematopoietic stem cell transplantation.

MeSH terms

Child
China / epidemiology
Costs and Cost Analysis
Hematopoietic Stem Cell Transplantation* / adverse effects
Humans
Transplantation, Autologous / adverse effects
Transplantation, Homologous / adverse effects