Weeks F M, Yee G C, Bartfield A A, Wingard J R
Division of Hematology/Oncology, College of Pharmacy, University of Florida, Gainesville 32610-0277, USA.
Am J Med Sci. 1997 Aug;314(2):101-12. doi: 10.1097/00000441-199708000-00012.
Bone marrow transplantation is an example of a highly technical therapy that offers hope to patients with bone marrow failure or various malignancies. Bone marrow transplantation is much more costly "up-front" but perhaps not more costly long-term than alternative therapies. Although economic analyses appear relatively simple, interpretation and use can be problematic. Several economic analyses have identified complications that occur frequently and affect the reported cost-effectiveness of high-dose chemotherapy. Efforts to reduce the cost of bone marrow transplantation have focused on new strategies to more effectively control these complications. The introduction of new technologies to speed engraftment, to improve patient selection methods, and the shifting of care to outpatient settings all have resulted in significant reductions in duration of hospital stay, treatment-related mortality, and costs. More studies of long-term outcomes are needed for transplant and nontransplant treatment options to guide present and future applications of this treatment option.
骨髓移植是一种高科技治疗手段的范例，它为骨髓衰竭或各种恶性肿瘤患者带来了希望。骨髓移植在“前期”成本要高得多，但从长期来看，或许并不比其他替代疗法成本更高。尽管经济分析看似相对简单，但解读和应用可能存在问题。多项经济分析已经确定了经常出现的并发症，这些并发症会影响高剂量化疗所报告的成本效益。降低骨髓移植成本的努力集中在更有效控制这些并发症的新策略上。引入加速植入的新技术、改进患者选择方法以及将护理转移到门诊环境，所有这些都显著缩短了住院时间、降低了治疗相关死亡率并减少了成本。对于移植和非移植治疗方案，需要更多关于长期结果的研究，以指导这种治疗方案目前和未来的应用。
