Saeed Alisha, Tasleem Zermina, Muhammad Sohail Ayaz, Ur Rehman Anees, Shah Shahid, Jamil Qurratul Ain, Siddiqui Hajra, Karuniawati Hidayah, Al-Tamimi Saleh Karamah
Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan.
Department of Political Sciences, Bahauddin Zakariya University, Multan, Pakistan.
Pharmacoecon Open. 2025 May;9(3):365-378. doi: 10.1007/s41669-024-00554-y. Epub 2025 Apr 1.
Acute myeloid leukemia (AML) is a heterogenous malignancy whose management is associated with considerable healthcare resource utilization and high expenditures because of recurrent and extended hospitalizations, multiple outpatient visits, and a wide range of supportive care. Modern therapies with improved safety profiles may assist in reducing healthcare costs; however, they are usually more expensive than standard chemotherapies. Few studies have addressed the expenses and burden of AML. Most of these studies were conducted in the USA. Very little research is available from the European Union (EU).
The aim of this study was to assess the economic impact of AML and determine the major cost-driving factors for its treatment in the EU.
This systematic review is in accordance with PRISMA guidelines. A systematic search was conducted using PubMed, Embase, ScienceDirect, SCOPUS, and Google Scholar databases to identify relevant studies on the economic impact of AML in various countries of the EU, published before April 15, 2024. Original studies investigating direct costs including expenses for treatment and healthcare services, or resource utilization for AML management were included. The systematic review excluded commentaries, editorials, and pharmacoeconomic modeling studies. Two reviewers independently performed data extraction and quality assessment, and the third reviewer resolved disagreements. We employed the Allison Larg Cost-of-Illness Studies evaluation checklist to assess the risk of bias. The mean cost per patient for induction, consolidation, and transplantation was calculated, and the results were converted into 2024 Euros.
Twenty-eight studies met our inclusion criteria, with the sample size of AML patients ranging from 12 to 39,568. The calculated per-patient direct costs of induction chemotherapy in Spain, France, Netherlands, Germany, and Italy were €92,378, €77,844, €61,643, €46,113, and €20,254, respectively. The mean per-patient direct cost of consolidation chemotherapy in the Netherlands and Germany was €42,137, and €32,220, respectively. The mean per-patient direct costs of transplantation in Sweden, Austria, France, Netherlands, and Spain were €192,628, €188,453, €132,352, €122,760, and €47,968, respectively. The cost-driving factors associated with AML treatment were inpatient hospitalization and medication costs.
AML seems to incur substantial direct economic expenses. Reducing the days of hospitalization can significantly decrease the economic burden of AML in the European Union. Moreover, there is a necessity for studies that comprehensively evaluate the economic implications, particularly concerning total and indirect costs.
Registered in PROSPERO under the registration number 'CRD42024537725'.
急性髓系白血病（AML）是一种异质性恶性肿瘤，由于复发和长期住院、多次门诊就诊以及广泛的支持治疗，其治疗与大量医疗资源的使用和高额费用相关。安全性更高的现代疗法可能有助于降低医疗成本；然而，它们通常比标准化疗更昂贵。很少有研究涉及AML的费用和负担。这些研究大多在美国进行。来自欧盟（EU）的研究非常少。
本研究旨在评估AML的经济影响，并确定其在欧盟治疗的主要成本驱动因素。
本系统评价符合PRISMA指南。使用PubMed、Embase、ScienceDirect、SCOPUS和谷歌学术数据库进行系统检索，以识别2024年4月15日前发表的关于欧盟各国AML经济影响的相关研究。纳入调查直接成本（包括治疗和医疗服务费用）或AML管理资源利用情况的原始研究。系统评价排除评论、社论和药物经济学建模研究。两名评审员独立进行数据提取和质量评估，第三名评审员解决分歧。我们采用Allison Larg疾病成本研究评估清单来评估偏倚风险。计算了每位患者诱导、巩固和移植的平均成本，并将结果换算成2024年欧元。
28项研究符合我们的纳入标准，AML患者样本量从12至39568例不等。西班牙、法国、荷兰、德国和意大利每位患者诱导化疗的直接成本分别计算为92378欧元、77844欧元、61643欧元、46113欧元和20254欧元。荷兰和德国每位患者巩固化疗的平均直接成本分别为42137欧元和32220欧元。瑞典、奥地利、法国、荷兰和西班牙每位患者移植的平均直接成本分别为192628欧元、188453欧元、132352欧元、122760欧元和47968欧元。与AML治疗相关的成本驱动因素是住院费用和药物成本。
AML似乎会产生大量直接经济费用。减少住院天数可显著降低欧盟AML的经济负担。此外，有必要进行全面评估经济影响的研究，特别是关于总成本和间接成本的研究。
在PROSPERO注册，注册号为“CRD42024537725”
