Direct cost analysis of the second year post-allogeneic hematopoietic stem cell transplantation in the Bone Marrow Transplant Centre of Tunisia

Background: Hematopoietic stem cell transplantation (HSCT) is a medically complicated therapy with a long recovery time. In Tunisia, the National Health Insurance Fund (CNAM) covers only the first year post-transplantation, after which the costs are borne by the hospital. Objective: Describe complic...

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Main Authors: Myriam Razgallah Khrouf, Leila Achour, Asma Thabti, Mohamed Ali Soussi, Nour Abdejelil, Olfa Lazreg, Chema Drira, Aida Zahaf, Saloua Ladab, Tarek Ben Othman
Format: Article
Language:English
Published: MDPI AG 2017-01-01
Series:Journal of Market Access & Health Policy
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Online Access:http://dx.doi.org/10.1080/20016689.2017.1335161
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author Myriam Razgallah Khrouf
Leila Achour
Asma Thabti
Mohamed Ali Soussi
Nour Abdejelil
Olfa Lazreg
Chema Drira
Aida Zahaf
Saloua Ladab
Tarek Ben Othman
author_facet Myriam Razgallah Khrouf
Leila Achour
Asma Thabti
Mohamed Ali Soussi
Nour Abdejelil
Olfa Lazreg
Chema Drira
Aida Zahaf
Saloua Ladab
Tarek Ben Othman
author_sort Myriam Razgallah Khrouf
collection DOAJ
description Background: Hematopoietic stem cell transplantation (HSCT) is a medically complicated therapy with a long recovery time. In Tunisia, the National Health Insurance Fund (CNAM) covers only the first year post-transplantation, after which the costs are borne by the hospital. Objective: Describe complications that can occur during the second year post-allogeneic HSCT and calculate direct costs in different groups of patients. Methods: In this pharmacoeconomic study, medical records of the second year post-allogeneic HSCT were collected. Studied variables included frequent observed complications and medical and non-medical direct costs. Results: The average total direct cost in the population during the second year post-transplantation was $11,571, 97% of which represents direct medical costs Drugs accounted for the largest share (80%) of total direct costs, dominated by the cost of antifungals (52%) and antivirals (26%) drug . Cytomegalovirus status was seen in 9.3% of patients and was associated with a seven-fold increase in direct costs (p < 0.001).​​In patients who developed chronic GVHD, the average direct cost was three times higher than for those who did not (p = 0.032). Conclusion: Given the importance of direct costs in the post-transplantation period a review of the hospital financing mechanism and a new convention with the CNAM is crucial.​​
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spelling doaj-art-bd1f0157bcfa4792a753ad867b6754ac2025-08-20T02:00:30ZengMDPI AGJournal of Market Access & Health Policy2001-66892017-01-015110.1080/20016689.2017.13351611335161Direct cost analysis of the second year post-allogeneic hematopoietic stem cell transplantation in the Bone Marrow Transplant Centre of TunisiaMyriam Razgallah Khrouf0Leila Achour1Asma Thabti2Mohamed Ali Soussi3Nour Abdejelil4Olfa Lazreg5Chema Drira6Aida Zahaf7Saloua Ladab8Tarek Ben Othman9Centre National de Greffe de Moelle OsseuseCentre National de Greffe de Moelle OsseuseCentre National de Greffe de Moelle OsseuseCentre National de Greffe de Moelle OsseuseCentre National de Greffe de Moelle OsseuseCentre National de Greffe de Moelle OsseuseCentre National de Greffe de Moelle OsseuseCentre National de Greffe de Moelle OsseuseCentre National de Greffe de Moelle OsseuseCentre National de Greffe de Moelle OsseuseBackground: Hematopoietic stem cell transplantation (HSCT) is a medically complicated therapy with a long recovery time. In Tunisia, the National Health Insurance Fund (CNAM) covers only the first year post-transplantation, after which the costs are borne by the hospital. Objective: Describe complications that can occur during the second year post-allogeneic HSCT and calculate direct costs in different groups of patients. Methods: In this pharmacoeconomic study, medical records of the second year post-allogeneic HSCT were collected. Studied variables included frequent observed complications and medical and non-medical direct costs. Results: The average total direct cost in the population during the second year post-transplantation was $11,571, 97% of which represents direct medical costs Drugs accounted for the largest share (80%) of total direct costs, dominated by the cost of antifungals (52%) and antivirals (26%) drug . Cytomegalovirus status was seen in 9.3% of patients and was associated with a seven-fold increase in direct costs (p < 0.001).​​In patients who developed chronic GVHD, the average direct cost was three times higher than for those who did not (p = 0.032). Conclusion: Given the importance of direct costs in the post-transplantation period a review of the hospital financing mechanism and a new convention with the CNAM is crucial.​​http://dx.doi.org/10.1080/20016689.2017.1335161Allogeneic stem cell transplantationcomplicationscostpharmacoeconomic
spellingShingle Myriam Razgallah Khrouf
Leila Achour
Asma Thabti
Mohamed Ali Soussi
Nour Abdejelil
Olfa Lazreg
Chema Drira
Aida Zahaf
Saloua Ladab
Tarek Ben Othman
Direct cost analysis of the second year post-allogeneic hematopoietic stem cell transplantation in the Bone Marrow Transplant Centre of Tunisia
Journal of Market Access & Health Policy
Allogeneic stem cell transplantation
complications
cost
pharmacoeconomic
title Direct cost analysis of the second year post-allogeneic hematopoietic stem cell transplantation in the Bone Marrow Transplant Centre of Tunisia
title_full Direct cost analysis of the second year post-allogeneic hematopoietic stem cell transplantation in the Bone Marrow Transplant Centre of Tunisia
title_fullStr Direct cost analysis of the second year post-allogeneic hematopoietic stem cell transplantation in the Bone Marrow Transplant Centre of Tunisia
title_full_unstemmed Direct cost analysis of the second year post-allogeneic hematopoietic stem cell transplantation in the Bone Marrow Transplant Centre of Tunisia
title_short Direct cost analysis of the second year post-allogeneic hematopoietic stem cell transplantation in the Bone Marrow Transplant Centre of Tunisia
title_sort direct cost analysis of the second year post allogeneic hematopoietic stem cell transplantation in the bone marrow transplant centre of tunisia
topic Allogeneic stem cell transplantation
complications
cost
pharmacoeconomic
url http://dx.doi.org/10.1080/20016689.2017.1335161
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