Vargas Dora Fraga, Pereira Mariana Pinto, Silva Tatiana Schnorr, de David Caroline Nespolo, Paz Alessandra Aparecida, Astigarraga Claudia Caceres
Hospital Moinhos de Vento, Porto Alegre, RS, Brazil.
Hospital Moinhos de Vento, Porto Alegre, RS, Brazil.
Hematol Transfus Cell Ther. 2023 Apr-Jun;45(2):182-187. doi: 10.1016/j.htct.2021.08.014. Epub 2021 Dec 9.
Although extracorporeal photopheresis (ECP) is a promising second-line therapy in the treatment of chronic graft-versus-host disease (cGVHD), its use is limited by its high cost. This study aims to describe the clinical evolution of patients who underwent ECP therapy for cGVHD and to perform an economic analysis of the therapy METHODS: This was a case series between 2016 and 2020 describing the clinical response to ECP and a micro-cost analysis of the therapy using time-driven activity-based costing.
Six patients underwent ECP for corticosteroid-dependent cGVHD The cost per ECP session is 14,960.90 Brazilian reais (BRL), which primarily consists of the ECP kit with an activator (82.78%), followed by the hospital's physical structure (14.66%), human resources (2.48%) and exams/inputs (0.08%). The number of sessions performed ranged from 2 to 42. The total cost of the therapy per patient ranged from BRL 30,000 to 500,000.
The response of the patient with cGVHD to treatment with ECP was variable. These micro-costing results can be used to develop remuneration and cost control strategies in hematopoietic stem cell transplantation programs, as well as in further economic studies.
尽管体外光化学疗法（ECP）在慢性移植物抗宿主病（cGVHD）的治疗中是一种很有前景的二线疗法，但其应用受到高成本的限制。本研究旨在描述接受ECP治疗cGVHD患者的临床病程，并对该疗法进行经济分析。方法：这是一个2016年至2020年的病例系列，描述了对ECP的临床反应以及使用时间驱动作业成本法对该疗法进行的微观成本分析。
6例患者因依赖皮质类固醇的cGVHD接受了ECP治疗。每次ECP治疗的成本为14,960.90巴西雷亚尔（BRL），主要由带激活剂的ECP试剂盒组成（82.78%），其次是医院的物理结构（14.66%）、人力资源（2.48%）和检查/耗材（0.08%）。进行的治疗次数从2次到42次不等。每位患者的治疗总成本从30,000巴西雷亚尔到500,000巴西雷亚尔不等。
cGVHD患者对ECP治疗的反应各不相同。这些微观成本计算结果可用于制定造血干细胞移植项目中的薪酬和成本控制策略，以及进一步的经济研究。
