The cost of hematopoietic stem cell transplantation in the real world.

In Brazil, the majority of the population does not have private health insurance and the government provides universal health care. Our 'Unique Healthcare System' pays for 95% of the 1500 hematopoietic stem cell transplants (HSCT) performed in the country every year. Hospitals are reimbursed a flat rate, ranging from US$ 13,000 for autologous to US$ 40,500 for unrelated donor transplants, excluding expenses with donor search and acquisition of the graft. The actual cost of the procedure is not captured routinely. Because unrelated donor recipients may have many clinical complications, most HSCT centers offer few or no beds to perform such transplants. The Pediatric Oncology Institute - GRAACC - is a non-profit organization that provides comprehensive care at no cost to the families, including unrelated donor HSCT. We are evaluating retrospectively the unrelated donor transplant costs to have data to present to the health authorities, looking for an appropriate funding formula for HSCT.