International Journal of Hematology

, Volume 76, Supplement 1, pp 365–367 | Cite as

The importance of lowering the costs of stem cell transplantation in developing countries

  • Ronald D. Barr
Some Modifications in the Stem Cell Transplantation (SCT) Procedures Render them Affordable for Developing Countries


The effectiveness and efficiency of health care systems can be assessed by economic evaluation, comparing the costs and outcomes of alternative interventions. Direct costs include accommodation, nursing, physicians’ fees, diagnostic tests and treatment. Indirect costs derive from the loss of a persons ability to use life in a productive way e.g. employment. In cost-effectiveness analyses, cost is the numerator and effectiveness (related to health outcomes) is the denominator. The unit of measurement of effectiveness is usually years of life saved. Cost utility analyses require a preference-based measurement of health-related quality of life (HRQL) to allow the calculation of utility scores for health states and so the adjustment of effectiveness for quality. Typically, this allows the calculation of qualityadjusted life years (QALYs). A review of published reports, to be presented in detail, yields the following summation. The greater cost of stem cell harvest from peripheral blood is more than offset by the reduced costs associated with a shorter hospital stay. Transplants early in first remission cost less than those undertaken at later points in disease evolution/treatment experience. Changing the primary locus of care from inpatient to outpatient may result in notable cost savings but can produce cost-shifting (from inpatient to outpatient). Nevertheless, in selected patient, the use of non-myeloablative transplants may offer a cost-effective option, especially in the developing country context.


Acute Myeloid Leukemia Stem Cell Transplantation Bone Marrow Transplantation Utility Score Peripheral Blood Stem Cell 
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Copyright information

© The Japanese Society of Hematology 2002

Authors and Affiliations

  • Ronald D. Barr
    • 1
  1. 1.Department of Pediatrics, Pathology and MedicineMcMaster UniversityCanada

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