Costo directo de la farmacoterapia de la leucemia aguda en el Hospital Clínico Regional de Valdivia, Chile: análisis del período 2003 a 2006 / Direct costs of pharmacotherapy for acute leukemia at a Regional Hospital in Chile

Background: In Chile, leukemia is one of the diseases whose treatment is guaranteed by a special law called AUGE (universal access and explicit guaranties). Therefore, the knowledge of its treatment costs is of utmost importance. Aim: To determine and to characterize the direct costs of pharmacotherapy for leukemia at a regional hospital in Chile. Material and methods: Data were retrospectively obtained from electronic and manual records of the hospital for all patients treated for leukemia between 2003 and 2006. Patients were classified into four groups: pediatric and adult patients treated for acute lymphocytic leukemia (ALL children and ALL adults, respectively), and pediatric and adult patients treated for acute myelogenous leukemia (AML children and AML adults, respectively). Results: Total accumulated costs of pharmacotherapy for acute leukemia between 2003 and 2006 were 304,724,845 Chilean pesos (USD 574,952). The higher total or per patient costs, were generated by drugs for chemotherapy compared to other required medications. The exception were AML children, where support drugs, such as antimicrobials, ant emetic drugs and colony stimulating factors, generated the higher costs per patient. Among ALL adults, AML children and AML adults, the costs were concentrated in the first 6 months of treatment. NO children followed this tendency concentrating the costs between the seventh and twenty-fourth months. Conclusions: Annual costs of pharmacotherapy per patient for acute leukemia in this regional hospital were approximately USD 4,717. Chemotherapy was the item with the greatest impact on cost.

Treating leukemia in a resource poor setting.

Acute lymphatic leukemia (ALL) is the commonest childhood malignancy in India; most patients have no access to specialized health care. Our experience in treating such children who are unable to avail of facilities at specialized centers is described here. The case records of 79 patients with acute lymphatic leukemia, treated at a Government Medical College in Kerala over 15 years were analyzed. Of the 73 patients who completed treatment, 23 survived (36%) 20 had event-free survival more than 5 years after remission. The utilization of available resources is described. We suggest twinning between specialized centers in India and peripheral hospitals as a means to reach more children.