A COMPARATIVE STUDY ON PHARMACOECONOMIC ANALYSIS OF RHEUMATOID ARTHRITIS PATIENT IN TWO DIFFERENT HOSPITALS IN TAMIL NADU

Objective: The objective of the present study is to compare the prescribing patterns and cost of illness of Rheumatoid arthritis patients in two different hospitals. Methods: This is an observational study conducted in two different tertiary care hospitals in Salem district after obtaining approval of the Institutional Ethics Committee (IEC) (Registration Number EC/PHARM D/2019.06). A sample size of 102 (above 18 y) patients were included (52 from group 1 hospital and 50 from group 2 hospital). The study was conducted over a period of 6 mo from February 2019 to July 2019. The cost was collected by a patient face-to-face interview. Results: Out of 102 patients, females (57.84%) patients were more prevalent than men with the age group of 50-59 y in both groups. Methotrexate was most commonly prescribed drug in group 1(36.5%), whereas in group 2 are Sulfasalazine (37%). Among the DMARDs unit cost of methotrexate is high but the monthly cost was high for Sulfasalazine, because the methotrexate is prescribed on a once-weekly basis while sulfasalazine is taken twice a day. The cost of NSAIDs comes around 46.47% of the total drug cost of the month. In steroids, cost comes around 11.73% of the total drug cost. Among the direct cost of two groups, the drug cost and transportation cost is higher when compared with other costs. Indirect costs such as lost wages, due to disease is higher in group 1. Conclusion: The study concluded that the burden of RA to the patient is huge, Appropriate standard prescribing guidelines should be developed and implementation of the rational drug must be promoted. Polypharmacy was reported in group 1 hospital, the progression of symptoms was the same in both hospitals, it increases the cost of therapy and overall cost of patients. Hence it becomes vital to diagnose and control the disease at an early stage to control the economic burden on the patient.

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MRI Spectrum of Japanese Encephalitis in Northeast India: A Cross-Sectional Study

Journal of Neurosciences in Rural Practice ◽

10.1055/s-0041-1722820 ◽

2021 ◽

Vol 12 (02) ◽

pp. 281-289

Author(s):

Pranjal Phukan ◽

Kalyan Sarma ◽

Barun Kumar Sharma ◽

Deb K. Boruah ◽

Bidyut Bikash Gogoi ◽

...

Keyword(s):

Japanese Encephalitis ◽

Statistical Significance ◽

Tertiary Care ◽

Care Hospital ◽

Mri Findings ◽

Mri Scan ◽

Cross Sectional ◽

Adc Value ◽

Group 2 ◽

Group 1

Abstract Objective Japanese encephalitis (JE) is an arthropod-borne flavivirus infection having high mortality and morbidity. This study was performed to evaluate the conventional magnetic resonance imaging (MRI) findings in JE and to find out any difference between pediatric and adult JE. Materials and Methods This retrospective study was performed on serologically positive 54 JE patients presented to a tertiary care hospital with acute encephalitic symptoms between April 2016 and October 2019. Relevant neurological examination, cerebrospinal fluid analysis, and MRI scan of the brain were performed. Results Fifty-four JE patients (n = 31 males and n = 23 females) having 32 pediatric and 22 adult JE were included in the study sample. Group 1 JE (n = 16) patients had encephalitic symptoms with duration less than 15 days up to the day of MRI scan and group 2 JE (n = 38) had symptoms more than 15 days. Group 1 JE had mean apparent diffusion coefficient (ADC) value of 0.563 ± 0.109 (standard deviation [SD]) × 10–3 mm2/sec and group 2 JE had 1.095 ± 0.206 (SD) × 10–3 mm2/sec. The mean ADC value of pediatric JE was 0.907 ± 0.336 (SD) × 10–3 mm2/sec and adult JE was 0.982 ± 0.253 (SD) × 10–3 mm2/sec. Conclusion The majority of the JE patient shows abnormal signal alterations in bilateral thalami and substantia nigra. Diffusion-weighted imaging with ADC mapping helps in evaluating the stage of the JE. No statistical significance of the various conventional MRI findings was found between the pediatric JE and adult JE.

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SAT0140 SAFETY OF TOFACITINIB THERAPY IN HBSAG CARRIERS WITH RHEUMATOID ARTHRITIS: A PROSPECTIVE STUDY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.6353 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1008.2-1008

Author(s):

L. Fang ◽

Z. Lin ◽

Z. Liao ◽

O. Jin ◽

Y. Pan ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Viral Load ◽

Hepatitis B Virus ◽

Hepatitis B ◽

Hbv Infection ◽

Hbsag Carriers ◽

B Virus ◽

Group 2 ◽

A Prospective Study ◽

Group 1

Background:Targeted synthetic DMARDs (ts-DMARDs) are becoming more available and affordable in developing countries, where the prevalence of hepatitis B virus (HBV) infection is still an important public health issue. The safety of ts-DMARDs therapy in terms of the reactivation of hepatitis B virus (HBV) infection need more concern. Rare data from a prospective study focus on the use of ts-DMARDs in patients with concurrent rheumatoid arthritis (RA) and HBV infection were available by now.Objectives:To evaluate the influence of tofacitinib on reactivation of HBV infection in HBsAg carriers with RA.Methods:In this 52 weeks observation, HBsAg carriers with active RA (DAS28>5.1) despite failed combined treatment with MTX and other non-biological DMARDs were enrolled. Patients must have normal liver function prior to study. All patients received therapy with tofacitinib (5mg twice daily) and concomitant MTX (10-12.5mg/w). Entecavir was prescribed preventively for patients who had a baseline HBV load >2000 copy/ml (group 1), and Lamivudin for patients with HBV load ≤ 2000 copy/ml (group 2). Liver enzymes (AST/ALT) and HBV viral load were monitored every 4 weeks. Increased viral load and abnormal liver function were managed according to expert opinion.Results:Thirteen patients (10 female) were recruited. Nine patients had a baseline viral load >2000 copy/ml (group 1, with preventive Entecavir), and the other 4 patients had a viral load ≤ 2000 copy/ml (group 2, with preventive Lamivudin). Two patients from group 1 discontinued tofacitinib at week 12 due to ineffectiveness, and both continued taking Entecavir for another 3 months after the discontinuation of tofacitinib.No reactivation of hepatitis B was observed in patients from group 1. One patients (female, 54 years old) from group 2 underwent a mild increase of both ALT and AST (67 and 56 IU/L, respectively) at week 16. An elevated viral load (4.9e6 copies/ml, baseline 1.4e3) and a HBV YMDD mutant was also found. The tofacitinib treatment continued. After prescription of Adefovir (combined with the pre-existing Lamivudin), both liver enzyme and viral load decreased to normal range in 8 weeks and remained normal throughout the study.Conclusion:An aggressive Tofacitinib + MTX therapy may be a safe option for HBsAg carriers with cs-DMARDs refractory RA. More active and effective prophylaxis strategy may be recommended to reduce the risk of HBV reactivation during the treatment.References:[1]Chen YM, Huang WN, Wu YD, et al. Reactivation of hepatitis B virus infection in patients with rheumatoid arthritis receiving tofacitinib: a real-world study. Ann Rheum Dis 2018; 77:780-2.Disclosure of Interests: :None declared

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Association between Tumor Size and Bilateral Involvement in Papillary Thyroid Carcinoma

Journal of Thyroid Research ◽

10.1155/2016/8470252 ◽

2016 ◽

Vol 2016 ◽

pp. 1-3

Author(s):

Suna Erkilic ◽

Fatih Celenk ◽

Zehra Bozdag

Keyword(s):

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Tumor Size ◽

Surgical Procedure ◽

Tertiary Care ◽

Papillary Thyroid ◽

Tertiary Care Medical Center ◽

Group 3 ◽

Group 2 ◽

Group 1

Background. Tumor multifocality and bilaterality of papillary thyroid carcinoma (PTC) are important factors when selecting the most appropriate surgical procedure. The aim of this study was to assess the bilaterality rate in PTC and the relationship between the tumor size and bilaterality.Materials and Methods. Thyroidectomy specimens with a diagnosis of PTC were retrospectively reviewed in the Pathology Department of a tertiary care medical center. Specimens were divided into three groups according to the size of the primary and contralateral tumor foci. Tumors less than or equal to 1 cm in each lobe were included in group 1. Group 2 consisted of tumors greater than 1 cm in one lobe and less than 1 cm in the other lobe. Tumors greater than 1 cm in each lobe were included in group 3.Results. We identified 868 total thyroidectomy specimens with a diagnosis of PTC between 2001 and 2011. Of these cases, both thyroid lobes were involved in 262 cases (32%). There were 109 (42%), 121 (46%), and 32 cases (12%) in group 1, group 2, and group 3, respectively.Conclusion. Bilaterality is frequent in PTC and is not related to tumor size. Accordingly, the high frequency of bilateral disease in PTC should be kept in mind when determining the extent of the surgical procedure.

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Efficacy of Probiotic Saccharomyces boulardii as an Adjuvant Therapy in Acute Childhood Diarrhoea

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v36i3.15539 ◽

2017 ◽

Vol 36 (3) ◽

pp. 250-255 ◽

Cited By ~ 5

Author(s):

Dillip Kumar Dash ◽

Mrutunjaya Dash ◽

M.D. Mohanty ◽

Naresh Acharya

Keyword(s):

Hospital Stay ◽

Tertiary Care ◽

Acute Diarrhoea ◽

Oral Rehydration Therapy ◽

Saccharomyces Boulardii ◽

Care Hospital ◽

Oral Rehydration ◽

Group 2 ◽

A Prospective Study ◽

Group 1

Introduction: Administration of S. boulardii in addition to rehydration therapy in diarrhea found to be beneficial in many aspects owing to a variety of causes and importantly it is was not associated with any adverse effects.Material and Methods: We conducted a prospective study of children suffering from acute diarrhoea, at a private tertiary care hospital. Children were divided into 2 groups randomly as per odd(Group 1 ) and even (Group 2) bed allotted in indoor at the time of admission: Group 1 included children on oral rehydration therapy (ORT) + Zinc + Saccharomyces boulardii (Probiotic 5 billion CFU twice daily) and Group 2 comprised of children on ORT+ Zinc. Our objective was to systematically review data on the effect of S. boulardii on acute childhood diarrhoea.Results: Out of a total of 126 children less than 2 years, 2-6 years and 6-14 years were 72 (57.14%), 42(33.33%) and 12(09.52%) respectively. The duration of diarrhoea in Group 1 was 26.31 hours and Group 2 was 47.81 hours (p<0.01). The frequency of diarrhoea showed improvement within 24 and 72 hours in Group 1 and Group 2 respectively (p<0.01).Similarly, the mean duration of hospital stay was 2.68 days in Group 1 and 4.8 days in Group 2.The treatment cost was INR 850 and INR 1650 while social cost was INR 1250 and 2600 in Group 1 and 2 respectively.Conclusion:This study shows that S. boulardii reduced the duration, frequency and hospital stay of diarrhoea thereby reducing the treatment and social costs.J Nepal Paediatr Soc 2016;36(3):250-255

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Factors associated with rs1801394 of the methionine synthase reductase gene polymorphism in patients with rheumatoid arthritis

Modern Rheumatology Journal ◽

10.14412/1996-7012-2021-3-15-19 ◽

2021 ◽

Vol 15 (3) ◽

pp. 15-19

Author(s):

M. Yu. Krylov ◽

G. I. Gridneva ◽

Yu. V. Muravyev

Keyword(s):

Rheumatoid Arthritis ◽

Clinical Characteristics ◽

Methionine Synthase ◽

Nucleotide Polymorphisms ◽

Allelic Discrimination ◽

Methionine Synthase Reductase ◽

Reductase Gene ◽

Group 2 ◽

The Relationship ◽

Group 1

Clinical response to methotrexate (MT) therapy in rheumatoid arthritis (RA) can be predicted on the basis of some single nucleotide polymorphisms (SNPs) of genes, involved in folate metabolism. One of these SNPs is the rs1801394 (A66G) polymorphism of the methionine synthase reductase gene (MTRR). We investigated the association of this polymorphism with the clinical characteristics of RA patients after 6 months of MT therapy. Studies of the relationship between the response to MT therapy and the rs1801394 polymorphism have not been carried out in Russia previously.Objective: to study the possible association of the rs1801394 polymorphism with the clinical characteristics of patients with RA after 6 months of MT therapy.Patients and methods. The study included 60 patients with RA who met the ACR / EULAR criteria (2010) and received≥20 mg MT per week continuously. Based on the EULAR criteria, patients were divided into two groups: group 1 (n=30) with a good (DAS28>1.2) and group 2 (n=30) with an unsatisfactory (DAS28 <1.2) response to MT therapy. Genotyping of the rs1801394 polymorphism was performed by allelic discrimination using real-time polymerase chain reaction.Results and discussion. The frequency distribution of the A66G polymorphism genotypes in both groups was similar, however, in the 2nd group with an unsatisfactory response, there was a tendency towards a higher frequency of the mutant GG genotype (p=0.067). An association of the A66G polymorphism with gender and disease duration was found. In group 1, the AG genotype was more often detected in men than in women (p=0.017). In group 2, the AG genotype was also more common in men (p=0.075). In addition, in this group, carriers of the G allele (genotypes AG and GG) had a longer duration of the disease than carriers of the AA genotype (p=0.003 and p=0.005, respectively).Conclusion. In the present study, the relationship of the studied polymorphism rs1801394 of the MTRR gene with gender and duration of RA disease was established.

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Optimization of Plerixafor Utilization Based on Peripheral Blood CD34+ Count for Autologous Peripheral Blood Stem-Cell Collection

Blood ◽

10.1182/blood-2020-140171 ◽

2020 ◽

Vol 136 (Supplement 1) ◽

pp. 41-41

Author(s):

Gaurav K. Gupta ◽

Sera Perreault ◽

Stuart Seropian ◽

Christopher A. Tormey ◽

Jeanne E. Hendrickson

Keyword(s):

Multiple Myeloma ◽

Stem Cell ◽

Peripheral Blood ◽

Conflicts Of Interest ◽

Medical Center ◽

Tertiary Care ◽

Peripheral Blood Cd34 ◽

Tertiary Care Medical Center ◽

Group 2 ◽

Group 1

Introduction: Peripheral CD34+ cells may be mobilized using filgrastim (G-CSF) alone or in combination with chemotherapy. However, some patients also require plerixafor, an inhibitor of C-X-C chemokine receptor type-4, for adequate mobilization. Given its cost, judicious utilization of plerixafor is warranted. Material and Methods: A retrospective analysis of autologous stem-cell mobilization was performed at a tertiary-care medical center in adult patients with multiple myeloma and lymphoma; here we will focus on the utility of repeat plerixafor dosing. Patients were mobilized at the treating physician's discretion with filgrastim plus plerixafor or chemotherapy plus filgrastim plus plerixafor. Collections were initiated once peripheral CD34+ counts reached 20/µL (or 10/µL if chemotherapy mobilized); plerixafor was administered if these counts were not reached after 4 or 8 days, respectively, of filgrastim treatment. Results: Patients with multiple myeloma (86) or lymphoma (30) were evaluated. One hundred five were mobilized by filgrastim plus plerixafor and 11 by chemotherapy plus filgrastim plus plerixafor. No patient that received plerixafor with a CD34+ count <5/µL after chemotherapy mobilized the next day. The end collection goal was achieved in 86 (81.9%) of the filgrastim plus plerixafor group and 7 (63.6%) of the chemotherapy plus filgrastim plus plerixafor group. Patients given at least one dose of plerixafor were divided into groups based on collection goal, peripheral blood CD34+ cell count after 1 dose and the first day collection yield: Group 1) Goal of 3x10^6/kg and CD34+ count ≥ 30 cell/µL vs < 30 cell/µL; Group 2) Goal of 6x10^6/kg and ≥ 50% of collection goal after 1 day of collection vs CD34+ count < 50 cell/µL or < 50% of collection goal. Forty of 42 (95%) patients in Group 1 with a CD34+ count ≥ 30 cell/µL achieved their end collection goal after one plerixafor dose. Eighteen of 19 (95%) patients in Group 1 with a CD34+ count <30 cell/µL received a second dose of plerixafor and 8 (44.4%) achieved their end collection goal. Twenty-eight of 32 (87.5%) patients in Group 2 with ≥ 50% of collection goal achieved on the first day of collection reached their end collection goal after one plerixafor dose. Nine of 12 (75%) patients in Group 2 with a CD34+ count of < 50 cells/µL or <50% collection goal received an additional dose of plerixafor and 6 (66.7%) achieved their end collection goal. Conclusion: Based on these data, we have developed the following repeat plerixafor dosing algorithm: 1) for a collection goal is 3x10^6/kg, administer a second dose of plerixafor if the CD34+ count on the first day of collection is < 30 cell/µL, and 2) for a collection goal of 6x10^6/kg, administer a second dose of plerixafor if the CD34+ count on the first day of collection is < 50 cell/µL or if the first day of collection yields <50% of the end goal. This algorithm optimizes pharmacy, apheresis and stem cell processing resources. Disclosures No relevant conflicts of interest to declare.

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More than half of opioids prescribed to pediatric patients after ambulatory knee surgery are unused

Journal of Opioid Management ◽

10.5055/jom.2021.0663 ◽

2021 ◽

Vol 17 (4) ◽

pp. 311-320

Author(s):

Pamela Wendel, MD ◽

Danya DeMeo, BS ◽

Madison R. Heath, BS ◽

Alexandra T. Mackie, BA, PB-BS ◽

Haoyan Zhong, MPA ◽

...

Keyword(s):

Tertiary Care ◽

Knee Surgery ◽

Opioid Medication ◽

Prescribing Practice ◽

Observational Cohort ◽

The Mean ◽

Group 2 ◽

Study Participants ◽

Group 1

Objective: To determine the number of opioid pills remaining after pediatric ambulatory knee surgery to provide insight into how many pills are actually used. Design: Prospective observational cohort study. Participants who were expected to be prescribed 20 (Group 1) versus 40 (Group 2) opioid pills according to the institutional policy (based on the type of surgery) were studied. Patient’s reported pain, medication use, and number of opioid pills remaining at postoperative days (PODs) 7 and 14. Participants were not randomly assigned to groups and no intervention was applied.Setting: An urban tertiary care musculoskeletal institution.Participants: Sixty adolescents between the ages of 12 and 19 undergoing ambulatory knee surgery.Interventions: Observational study, no experimental study intervention.Main outcome measure: The total number of opioid pills remaining.Results: By POD7, more than 70 percent of patients had stopped taking their prescribed opioid medication mainly because their knee pain was tolerable either without the opioid or by using other medications. By POD14, the mean number of pills taken was 6.3 ± 5.3 for Group 1 and 18.4 ± 13.9 for Group 2. The mean number of unused opioids was 13.5 ± 7.2 for Group 1 and 17.9 ± 13.7 for Group 2. Conclusions: Even with prescribing practice guidelines in place, opioids may be overprescribed and could be given in a smaller quantity without affecting the quality of acute postoperative pain control in adolescents undergoing ambulatory knee surgery. However, one needs to consider that some patients may need a larger than average amount in order to be appropriately treated for their level of pain and thus prescription amounts—preferably after reevaluation—should be individualized.

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AN EVALUATION ON PRESCRIBING PATTERN OF ANTIBIOTICS IN PAEDIATRIC INPATIENTS AT TERTIARY CARE HOSPITAL

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2019.v12i12.35074 ◽

2019 ◽

pp. 53-57

Author(s):

SABISHRUTHI S ◽

KAVITHA S ◽

JAGAN NATHAN B ◽

KALICHETI PRIYANKA ◽

ARSHATH A

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Minimum Cost ◽

Prescribing Patterns ◽

Care Hospital ◽

Sensitivity Testing ◽

Prescribing Pattern ◽

Case Record ◽

Tract Infections ◽

The Cost

Objective: Our objective of the study was to evaluate the prescribing patterns of drugs with cost analysis in pediatric inpatients at tertiary care hospital. Methods: It is an observational prospective study carried out in pediatric inpatients with a sample of 180 patients based on age, inclusion, and exclusion criteria for period of 3 months. The patient’s data were collected using patient case record form and analysis of the data was done. Results: Of 180 patients data were collected, the results show that majority of gender admitted in the hospital were male children 94 (52%) and many are from age group of early childhood (2–5 years) 67 (37%). Respiratory tract infections are diagnosis most commonly analyzed and off overall 236 prescribed antibiotics cephalosporins 86 (43%) and combination of amoxicillin + clavulanic acid 25 (71%) is the class of antibiotics prescribed higher than other class of drugs. Parental 173 (73%) route of administration was observed to be followed more than other route. The percentage of cost variation of antibiotics observed in the study reveals that the huge variations were seen in the cost of medication in maximum and minimum cost. Conclusion: The present study reveals that the prescribed antibiotics were as per the diagnosis of the patient and not by proceeding proper culture sensitivity testing. Hence, awareness about antibiotic must be created among practicing physicians to increase the therapeutic compliance of the patient.

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Postpartum Morbidity Associated With Advanced HIV Disease

Infectious Diseases in Obstetrics and Gynecology ◽

10.1155/idog/2006/79512 ◽

2006 ◽

Vol 2006 ◽

pp. 1-5 ◽

Cited By ~ 5

Author(s):

Judette Louis ◽

Mudathiru A. Buhari ◽

Dianne Allen ◽

Bernard Gonik ◽

Theodore B. Jones

Keyword(s):

Cesarean Delivery ◽

Care Center ◽

Tertiary Care ◽

Wound Complication ◽

Hiv Disease ◽

Increased Risk ◽

Group 3 ◽

Group 2 ◽

Advanced Hiv Disease ◽

Group 1

Objective. To investigate the postpartum morbidity and postpartum management of febrile morbidity associated with advanced HIV infection. Methods. A case control study of HIV infected women at a tertiary care center during January 2000–June 2005 was performed. Postpartum morbidity was defined as endometritis, blood transfusion, wound complication, readmission, infectious morbidity, or unexpected surgery. Results. Women in Group 1 had AIDS (N=33), Group 2 were relatively immunocompetent HIV infected women (N=115), and Group 3 were uninfected women (N=152). Group 1 was more likely to have a postpartum morbidity (32.3 versus 19.3 and 13.2%,P=.03) and to have postpartum imaging 18.8 versus 7.9 and 2.6%,P=.002. After controlling for potential confounders, cesarean delivery (OR 6.2, 95%CI 2.1–505.5) but not advanced HIV disease was associated with an increased risk of postpartum morbidity. Conclusion. Cesarean delivery and not advanced HIV disease increases the risk of postpartum morbidity in women with AIDS.

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Cost Analysis of Immunotherapy Using Dendritic Cells for Acute Myeloid Leukemia Patients

Blood ◽

10.1182/blood.v124.21.1322.1322 ◽

2014 ◽

Vol 124 (21) ◽

pp. 1322-1322 ◽

Cited By ~ 2

Author(s):

Ann L. Van de Velde ◽

Sébastien Anguille ◽

Philippe Beutels ◽

Suzy Dom ◽

Ingrid Cornille ◽

...

Keyword(s):

Dendritic Cell ◽

Myeloid Leukemia ◽

Dendritic Cell Vaccination ◽

Consolidation Therapy ◽

Median Cost ◽

Remission Status ◽

Group 3 ◽

Group 2 ◽

The Cost ◽

Group 1

Abstract INTRODUCTION: Treatment for acute myeloid leukemia (AML) presents a significant economic burden to patients, health care insurers and society, and is expected to remain so in the near future. There are few studies describing the costs of AML in the literature. However, the high cost of treating AML and the demographic evolution of the world population, indicate that such studies are needed to support ongoing efforts to allocate resources efficiently in health care. OBJECTIVE: To describe and compare the costs of AML therapies daily used at the Antwerp University Hospital in adult patients receiving chemotherapy with/without stem cell transplantation and in patients receiving immunotherapy using dendritic cell vaccination. DESIGN AND METHODS: This monocentric study compares direct hospital medical costs of treatment for AML between 2005 and 2010, allocated and charged according to the hospital analytic accounting system. Information on use of medical resources was collected from electronic medical records. Professional and facility charges associated with inpatient and outpatient management were collected using electronic billing information. Drug costs and drug administration costs were based on list prices published by the Belgian reimbursement authority (RIZIV/INAMI). The cost analysis distinguished between group 1, patients treated with induction and consolidation therapy alone; group 2, patients treated with induction and consolidation therapy plus allogeneic hematopoietic stem cell transplantation (HSCT) and group 3, patients treated with induction and consolidation therapy plus immunotherapy using dendritic cells engineered to express the Wilms’ tumor protein (Van Tendeloo et al. Proc Natl Acad Sci USA. 2010;107(31):13824-9). RESULTS AND DISCUSSION: 51 adult patients who were treated for newly diagnosed AML were included. Costs on medical and nursing care at the hematology ward, pharmaceutical prescriptions, transfer episodes to the intensive care ward, laboratory tests and medical imaging were analyzed. The cost of dendritic cell vaccine preparation was € 20 450 per patient. The median cost in group 1 (15 patients) was € 32,648 (range: € 4,759 - € 140,383). Only 1 patient in group 1 went into remission after induction therapy and received consolidation therapy. All patients in group 1 died within 5 year after diagnosis, 13 patients died within 1 year and 5 died within 1 month. The median cost in group 2 (26 patients) was € 184,554 (range: € 87,932 - € 449,155). The median post-consolidation treatment cost in group 2 was € 110,430 (range: € 31,364 - € 255,948). Five-year survival in group 2 was 19%. Seventeen patients in group 2 died within 1 year after HSCT. The median cost in group 3 (10 patients) was € 88,635 (range: € 23,392 - € 215,119). The median post-consolidation treatment cost in group 3 was € 40,748 (range: € 26,907- € 156,870). Five-year survival in group 3 was 30%. Four patients in group 3 died within 1 year after vaccination. CONCLUSION: This study comparing different post-consolidation therapies confirmes the high cost of treating AML and suggests that savings to the healthcare system could be achieved by sustaining complete remission status for longer periods. Dendritic cell vaccination is one of the new therapeutic options to attain a long remission status. Disclosures No relevant conflicts of interest to declare.

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