Table 2.

Summary of Cost-Identification Studies of HCT in the United States Published after 2000

Reference	Data Source	Population Characteristics	Costs	Conclusions/Remarks
Lee et al. [22]	Single institution, 1994-1997 Time horizon: hospital admission for conditioning until discharge	n = 236 (auto, allo: MRD, URD) Inpatient only; adult patients	Median costs: Auto: $55,500 Allo: $105,300	Overall costs were significantly higher for allo-HCT than for auto-HCT. Higher costs were driven by occurrence of major complications. Use of mismatched donors among allo-HCT recipients was a significant pre-HCT predictor of costs.
Saito et al. [20]	Single institution, 2000-2003 Time horizon: graft infusion through 1 year post-HCT	n = 275 (allo: MA, RIC) Inpatient and outpatient; adult patients	Median costs: Allo-MA: $128,253 Allo-RIC: $80,499	For 1 year after allo-HCT, RIC HCT was less expensive than MA HCT with comparable clinical outcomes. Costs were significantly higher for unrelated donor HCT than for related donor HCT. HCT was more costly for patients with advanced disease than for those with less advanced disease.
Saito et al. [21]	Single institution, 2000-2004 Time horizon: admission to 1 year post-HCT	n = 315 (allo: MRD, MUD) Inpatient only; adult patients	Median total cost over first year: $128,800	Room, pharmacy, and blood bank costs were the largest contributors to total costs in first 100 days post-HCT. Pretransplantation predictors of higher costs included the use of unrelated donors and advanced disease status. Both before and after HCT, complications were associated with higher costs.
Majhail et al. [19]	Single institution, 2004-2006 Time horizon: from 30 days before until 100 days after HCT	n = 294 (MA: MRD, UCB; RIC: MRD, UCB) Inpatient and outpatient; adult patients	Median costs: MA: $137,112 RIC: $84,824 UCB: $137,564 MRD: $83,583	Room and board and pharmacy services were the major contributors to total costs. UCB HCT was more expensive than MRD HCT, and MA HCT was more expensive than RIC HCT. Costs for both UCB HCT and MRD HCT were driven primarily by severe posttransplantation complications and prolonged inpatient stay.
Majhail et al. [28]	Single institution, 2004-2006 Time horizon: from 30 days before until 100 days after HCT	n = 146 (allo: MRD, MUD, UCB) Inpatient and outpatient; pediatric patients	Mean cost per day survived: MRD: $3,446 MUD: $4,050 UCB: $4,522	Costs of MUD HCT and UCB HCT were similar; MRD HCT was less costly. Room and board and pharmacy services were major contributors to total costs. Costs were driven primarily by post-HCT complications.
Jones et al. [23]	Secondary database analysis (HCUP NIS), 2000-2001 Time horizon: admission to discharge for single HCT hospitalization	n = 8,891 (auto) Inpatient only; adult patients	Mean costs: $51,312	Complications were associated with increased hospital costs. Use of total body irradiation was associated with longer hospital stay and higher hospital costs.

Allo indicates allogeneic; auto, autologous; HCUP NIS, Healthcare Cost and Utilization Project Nationwide Inpatient Sample; MA, myeloablative; MRD, matched related donor; MUD, matched unrelated donor.