Comparative treatment costs of risk‐stratified therapy for childhood acute lymphoblastic leukemia in India
Abstract 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 fac...
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| Format: | Article |
| Language: | English |
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Wiley
2023-02-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.5140 |
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| author | Tushar Mungle Nandana Das Saikat Pal Manash Pratim Gogoi Parag Das Niharendu Ghara Debjani Ghosh Ramandeep Singh Arora Nickhill Bhakta Vaskar Saha Shekhar Krishnan |
| author_facet | Tushar Mungle Nandana Das Saikat Pal Manash Pratim Gogoi Parag Das Niharendu Ghara Debjani Ghosh Ramandeep Singh Arora Nickhill Bhakta Vaskar Saha Shekhar Krishnan |
| author_sort | Tushar Mungle |
| collection | DOAJ |
| description | Abstract 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. |
| format | Article |
| id | doaj-art-a0d6cbe955a845ed96a2e10d31025320 |
| institution | Kabale University |
| issn | 2045-7634 |
| language | English |
| publishDate | 2023-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj-art-a0d6cbe955a845ed96a2e10d310253202024-11-25T07:56:32ZengWileyCancer Medicine2045-76342023-02-011233499350810.1002/cam4.5140Comparative treatment costs of risk‐stratified therapy for childhood acute lymphoblastic leukemia in IndiaTushar Mungle0Nandana Das1Saikat Pal2Manash Pratim Gogoi3Parag Das4Niharendu Ghara5Debjani Ghosh6Ramandeep Singh Arora7Nickhill Bhakta8Vaskar Saha9Shekhar Krishnan10Clinical Research Unit Tata Translational Cancer Research Centre, Tata Medical Center Kolkata IndiaClinical Research Unit Tata Translational Cancer Research Centre, Tata Medical Center Kolkata IndiaTata Consultancy Services Tata Translational Cancer Research Centre, Tata Medical Center Kolkata IndiaClinical Research Unit Tata Translational Cancer Research Centre, Tata Medical Center Kolkata IndiaClinical Research Unit Tata Translational Cancer Research Centre, Tata Medical Center Kolkata IndiaDepartment of Paediatric Haematology and Oncology Tata Medical Center Kolkata IndiaDepartment of Paediatric Haematology and Oncology Tata Medical Center Kolkata IndiaDepartment of Medical Oncology Max Super Speciality Hospital New Delhi IndiaDepartment of Global Pediatric Medicine St Jude Children's Research Hospital Memphis Tennessee USAClinical Research Unit Tata Translational Cancer Research Centre, Tata Medical Center Kolkata IndiaClinical Research Unit Tata Translational Cancer Research Centre, Tata Medical Center Kolkata IndiaAbstract 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.https://doi.org/10.1002/cam4.5140cost‐effectivenesslow‐middle income countriespediatric acute lymphoblastic leukemiarisk‐stratified therapytreatment cost |
| spellingShingle | Tushar Mungle Nandana Das Saikat Pal Manash Pratim Gogoi Parag Das Niharendu Ghara Debjani Ghosh Ramandeep Singh Arora Nickhill Bhakta Vaskar Saha Shekhar Krishnan Comparative treatment costs of risk‐stratified therapy for childhood acute lymphoblastic leukemia in India Cancer Medicine cost‐effectiveness low‐middle income countries pediatric acute lymphoblastic leukemia risk‐stratified therapy treatment cost |
| 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 | cost‐effectiveness low‐middle income countries pediatric acute lymphoblastic leukemia risk‐stratified therapy treatment cost |
| url | https://doi.org/10.1002/cam4.5140 |
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