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Induction-related cost of patients with acute myeloid leukaemia in France

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Abstract

Objective The economic profile of acute myeloid leukaemia (AML) is badly known. The few studies published on this disease are now relatively old and include small numbers of patients. The purpose of this retrospective study was to evaluate the induction-related cost of 500 patients included in the AML 2001 trial, and to determine the explanatory factors of cost. Setting “Induction” patient’s hospital stay from admission for “induction” to discharge after induction. Method The study was performed from the French Public Health insurance perspective, restrictive to hospital institution costs. The average management of a hospital stay for “induction” was evaluated according to the analytical accounting of Besançon University Teaching Hospital and the French public Diagnosis-Related Group database. Multiple linear regression was used to search for explanatory factors. Main outcome measure Only direct medical costs were included: treatment and hospitalisation. Results Mean induction-related direct medical cost was estimated at €41,852 ± 6,037, with a mean length of hospital stay estimated at 36.2 ± 10.7 days. After adjustment for age, sex and performance status, only two explanatory factors were found: an additional induction course and salvage course increased induction-related cost by 38% (±4) and 15% (±1) respectively, in comparison to one induction. These explanatory factors were associated with a significant increase in the mean length of hospital stay: 45.8 ± 11.6 days for 2 inductions and 38.5 ± 15.5 if the patient had a salvage course, in comparison to 32.9 ± 7.7 for one induction (P < 10−4). This result is robust and was confirmed by sensitivity analysis. Conclusion Consideration of economic constraints in health care is now a reality. Only the control of length of hospital stay may lead to a decrease in induction-related cost for patients with AML.

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Acknowledgments

We would like thank all centres contributing to this study and transmitting data from the French PMSI: Toulouse, Bordeaux, Nancy, Rennes, Strasbourg, Angers, Clermont-Ferrand, Besançon, Limoges, Saint Etienne, Nice, Tours, Dijon, Avignon, Colmar et Nîmes. We also thank Ms Pamela Albert for English assistance in the correction of the manuscript.

Conflicts of interest

The authors declare no conflict of interest with regard to this publication.

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Authors and Affiliations

  1. Department of Pharmacy, University Hospital of Besançon, 25030, Besançon, France

    Virginie Nerich, Maryline Rave & Marie-Christine Woronoff-Lemsi

  2. EA4267–UFR-133, School of Medicine and Pharmacy, 25000, Besançon, France

    Virginie Nerich & Marie-Christine Woronoff-Lemsi

  3. Department of Hematology, University Teaching Hospital, Strasbourg, France

    Bruno Lioure

  4. Department of Hematology, University Teaching Hospital, Toulouse, France

    Christian Recher

  5. Department of Hematology, University Teaching Hospital, Bordeaux, France

    Arnaud Pigneux

  6. Department of Hematology, University Teaching Hospital, Nancy, France

    Brigitte Witz

  7. Department of Hematology, University Teaching Hospital, Rennes, France

    Martine Escoffre-Barbe

  8. Department of Hematology, University Teaching Hospital, Angers, France

    Marie-Pierre Moles

  9. Department of Hematology, University Teaching Hospital, Nîmes, France

    Eric Jourdan

  10. Department of Hematology, University Teaching Hospital, Grenoble, France

    Jean Yves Cahn

  11. Centre Hospitalier Universitaire, Pôle Pharmaceutique, Boulevard Fleming, 25030, Besancon Cedex, France

    Marie-Christine Woronoff-Lemsi

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  1. Virginie Nerich
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  2. Bruno Lioure
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  3. Maryline Rave
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  4. Christian Recher
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  5. Arnaud Pigneux
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  6. Brigitte Witz
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  7. Martine Escoffre-Barbe
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  8. Marie-Pierre Moles
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  9. Eric Jourdan
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  10. Jean Yves Cahn
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  11. Marie-Christine Woronoff-Lemsi
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Correspondence to Marie-Christine Woronoff-Lemsi.

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On behalf the GOELAMS (Groupe Ouest-Est des Leucémies Aiguës et Autres Maladies du Sang)

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Nerich, V., Lioure, B., Rave, M. et al. Induction-related cost of patients with acute myeloid leukaemia in France . Int J Clin Pharm 33, 191–199 (2011). https://doi.org/10.1007/s11096-010-9462-1

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  • DOI: https://doi.org/10.1007/s11096-010-9462-1

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