دورية أكاديمية
أعرض في EDS

Cost-effectiveness of treating childhood acute myeloid leukemia at a tertiary care center in North India.

التفاصيل البيبلوغرافية
العنوان: Cost-effectiveness of treating childhood acute myeloid leukemia at a tertiary care center in North India.
المؤلفون: Srinivasan S; Department of Pediatric Oncology, Tata Memorial Hospital and ACTREC, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India., Bolous NS; Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee, USA., Batra A; Department of Transfusion Medicine, Homi Bhabha Cancer Hospital and Mahamana Pandit Madan Mohan Malaviya Cancer Centre, Tata Memorial Centre, Homi Bhabha National Institute, Varanasi, Uttar Pradesh, India., Bharti S; Department of Microbiology, Homi Bhabha Cancer Hospital and Mahamana Pandit Madan Mohan Malaviya Cancer Centre, Tata Memorial Centre, Homi Bhabha National Institute, Varanasi, Uttar Pradesh, India., Singh N; Department of Hematopathology, Homi Bhabha Cancer Hospital and Mahamana Pandit Madan Mohan Malaviya Cancer Centre, Tata Memorial Centre, Homi Bhabha National Institute, Varanasi, Uttar Pradesh, India., Shaikh T; Department of Pediatric Oncology, Homi Bhabha Cancer Hospital and Mahamana Pandit Madan Mohan Malaviya Cancer Centre, Tata Memorial Centre, Homi Bhabha National Institute, Varanasi, Uttar Pradesh, India., Yadav A; Department of Cytogenetics, Homi Bhabha Cancer Hospital and Mahamana Pandit Madan Mohan Malaviya Cancer Centre, Tata Memorial Centre, Homi Bhabha National Institute, Varanasi, Uttar Pradesh, India., Kanwar V; Department of Pediatric Oncology, Homi Bhabha Cancer Hospital and Mahamana Pandit Madan Mohan Malaviya Cancer Centre, Tata Memorial Centre, Homi Bhabha National Institute, Varanasi, Uttar Pradesh, India.
المصدر: Pediatric blood & cancer [Pediatr Blood Cancer] 2024 Aug 10, pp. e31242. Date of Electronic Publication: 2024 Aug 10.
Publication Model: Ahead of Print
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: John Wiley Country of Publication: United States NLM ID: 101186624 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1545-5017 (Electronic) Linking ISSN: 15455009 NLM ISO Abbreviation: Pediatr Blood Cancer Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Hoboken, N.J. : John Wiley, c 2004-
مستخلص: Introduction: Childhood cancers are a significant global health concern, particularly in low- and middle-income countries (LMICs), where over 80% of childhood cancer patients reside. In India, acute myeloid leukemia (AML) constitutes a significant portion of childhood cancers; however, the data on the cost-effectiveness of childhood AML treatment in India and other LMICs remain limited.
Methods: The study focused on children (<15 years of age) diagnosed with AML at a tertiary care cancer center in North India. Data, including treatment outcome, treatment-related morbidity, mortality, and costs were retrospectively collected from the electronic medical record and hospital database. Cost-effectiveness was assessed using disability-adjusted life years (DALY) averted in relation to the country-specific cost-effectiveness threshold.
Results: Among 59 AML patients, treatment-related high mortality rates, abandonment, and limited access to bone marrow transplantation were notable challenges. Intensive chemotherapy resulted in substantial sepsis-related complications, with treatment-related mortality reaching 30%. The 3-year event-free survival and overall survival of the 43 patients who received intensive therapy were 24.5% ± 7.6% and 27.9% ± 8.3%, respectively. Despite these challenges, treating childhood AML was still found to be cost-effective. The total cost per newly diagnosed patient treated with curative intent was $4454. Cost per DALY averted accounted for 24% of the gross domestic product (GDP) per capita, rendering the treatment to be cost-effective with a stringent cost-effectiveness threshold utilized.
Conclusion: The study underscores the challenges faced while treating childhood AML in LMICs, including treatment-induced high sepsis-related mortality and abandonment. Despite these challenges, it remains cost-effective to treat childhood AML in India. Future efforts should focus on reducing treatment-related morbidity and mortality to further improve outcomes and cost-effectiveness.
(© 2024 The Author(s). Pediatric Blood & Cancer published by Wiley Periodicals LLC.)
References: Force LM, Abdollahpour I, Advani SM, et al. The global burden of childhood and adolescent cancer in 2017: an analysis of the Global Burden of Disease Study 2017. Lancet Oncol. 2019;20(9):1211‐1225.
Fung A, Horton S, Zabih V, Denburg A, Gupta S. Cost and cost‐effectiveness of childhood cancer treatment in low‐income and middle‐income countries: a systematic review. BMJ Glob Health. 2019;4(5):1‐13. Doi:10.1136/bmjgh‐2019‐001825.
Arora RS, Bagai P, Bhakta N. Estimated national and state level incidence of childhood and adolescent cancer in India. Indian Pediatr. 2021;58(5):417‐423.
Arora RS, Arora B. Acute leukemia in children: a review of the current Indian data. South Asian J Cancer. 2016;5(3):155‐160.
Kulkarni KP, Marwaha RK. Childhood acute myeloid leukemia: an Indian perspective. Pediatr Hematol Oncol. 2011;28(4):257‐268.
Srinivasan S, Gollamudi VRM, Dhariwal N. Pediatric acute myeloid leukemia in India: a systematic review. Indian J Med Paediatr Oncol. 2022;43(4):342‐348.
Van Weelderen RE, Klein K, Natawidjaja MD, De Vries R, Kaspers GJL. Outcome of pediatric acute myeloid leukemia (AML) in low‐ and middle‐income countries: a systematic review of the literature. Expert Rev Anticancer Ther. 2021;21(7):765‐780.
Srinivasan S, Moulik NR, Patkar N, et al. KIT exon 17 mutations are predictive of inferior outcome in pediatric acute myeloid leukemia with RUNX1::RUNX1T1. Pediatr Blood Cancer. 2024;71(2):e30791.
Freifeld AG, Bow EJ, Sepkowitz KA, et al. Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the infectious diseases society of america. Clin Infect Dis. 2011;52(4):427‐431.
Magiorakos AP, Srinivasan A, Carey RB, et al. Multidrug‐resistant, extensively drug‐resistant and pandrug‐resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect. 2012;18(3):268‐281.
Fuentes‐Alabi S, Bhakta N, Vasquez RF, Gupta S, Horton SE. The cost and cost‐effectiveness of childhood cancer treatment in El Salvador, Central America: a report from the Childhood Cancer 2030 Network. Cancer. 2018;124(2):391‐397.
Lorna R, Shivani S, Nickhill B, Avram D, Sue H, Sumit G. Evidence from Ghana indicates that childhood cancer treatment in sub‐Saharan Africa is very cost effective: a report from the Childhood Cancer 2030 Network. J Glob Oncol. 2018;4:1‐9. doi:10.1200/jgo.17.00243.
Githang'a J, Brown B, Chitsike I, et al. The cost‐effectiveness of treating childhood cancer in 4 centers across sub‐Saharan Africa. Cancer. 2021;127(5):787‐793.
World development indicators: exchange rates and prices. World Bank Group. Accessed November 14, 2023. https://wdi.worldbank.org/table/4.16.
Soliman R, Oke J, Sidhom I, et al. Cost‐effectiveness of childhood cancer treatment in Egypt: lessons to promote high‐value care in a resource‐limited setting based on real‐world evidence. EClinicalMedicine. 2023;55(2022):101729. doi:10.1016/j.eclinm.2022.101729.
Pichon‐Riviere A, Drummond M, Palacios A, Garcia‐Marti S, Augustovski F. Determining the efficiency path to universal health coverage: cost‐effectiveness thresholds for 174 countries based on growth in life expectancy and health expenditures. Lancet Glob Health. 2023;11(6):e833‐e842.
India life expectancy: World Bank Group. Accessed November 14, 2023. https://data.worldbank.org/country/india.
Murray CJ, Lopez AD, Jamison DT. The global burden of disease in 1990: summary results, sensitivity analysis and future directions. Bull World Heal Organ. 1994;72(3):495‐509.
Yeh JM, Hanmer J, Ward ZJ, et al. Chronic conditions and utility‐based health‐related quality of life in adult childhood cancer survivors. J Natl Cancer Inst. 2016;108(9):djw046.
GDP per capita (current US$) ‐ India. World Bank Group. Accessed November 14, 2023. https://data.worldbank.org/indicator/NY.GDP.PCAP.CD?locations=IN.
Cotache‐Condor C, Kantety V, Grimm A, et al. Determinants of delayed childhood cancer care in low‐ and middle‐income countries: a systematic review. Pediatr Blood Cancer. 2023;70(3):e30175.
Cotache‐Condor C, Rice HE, Schroeder K, et al. Delays in cancer care for children in low‐income and middle‐income countries: development of a composite vulnerability index. Lancet Glob Health. 2023;11(4):e505‐e515.
Nguyen D, Kantarjian HM, Short NJ, et al. Early mortality in acute myeloid leukemia with KMT2A rearrangement is associated with high risk of bleeding and disseminated intravascular coagulation. Cancer. 2023;129(12):1856‐1865.
Jain H, Rengaraj K, Sharma V, et al. Infection prevalence in adolescents and adults with acute myeloid leukemia treated in an Indian tertiary care center. JCO Glob Oncol. 2020;6:1684‐1695.
Tripathi R, Jain P, Tarai B, Arora R. Factors associated with mortality from Gram‐negative bacterial infections in children with cancer. Pediatr Hematol Oncol J. 2023;8(1):41‐44.
Mishra SK, Panda SP, Sahoo D, Panda SS, Nayak PP, Debashrita S. Bloodstream infections in cancer patients: analysis from a tertiary cancer hospital in Bhubaneswar, Odisha, India. Oncol J India. 2020;4(2):49.
Radhakrishnan V, Bakhshi S, Kayal S, et al. Two‐drug versus three‐drug induction chemotherapy in pediatric acute myeloid leukemia: a randomized controlled trial. Blood Cancer J. 2022;12(9):131.
Bansal D, Davidson A, Supriyadi E, Njuguna F, Ribeiro RC, Kaspers GJL. SIOP PODC adapted risk stratification and treatment guidelines: recommendations for acute myeloid leukemia in resource‐limited settings. Pediatr Blood Cancer. 2023;70(11):e28087.
Srinivasan S, Keerthivasagam S. Transforming childhood AML care in India. J Pediatr Hematol Oncol. 2024;46(5):276‐277.
Pandey A, Deshpande P, Singh A, Singh S, Murari K, Aryan R. Oral prednisolone, etoposide, 6‐mercaptopurine (PREM) metronomic chemotherapy in treatment naïve and partially treated acute myeloid leukemia in a resource constrained setting. Cancer Res Stat Treat. 2020;3(2):172‐182.
Vey N. Low‐intensity regimens versus standard‐intensity induction strategies in acute myeloid leukemia. Ther Adv Hematol. 2020;11:204062072091301.
Bharat S, Rahul K, Indraneel D, et al. Impact of COVID‐19 pandemic on the pattern of blood donation and blood safety: experience from a hospital‐based blood center in North India. Asian J Transfus Sci. 2021;15(2):119.
Bewersdorf JP, Huntington SF, Zeidan AM. Cost‐effectiveness analyses in AML: what have we learned, how should this impact patient care, and what needs to be done in the future? J Natl Compr Cancer Netw. 2023;21(5):522‐528.
Sprehe MR, Johnson R. Using chargemaster data to understand childhood leukemia costs. Blood. 2016;128(22):5938‐5938.
Hutubessy R, Chisholm D, Tan‐Torres Edejer T, et al. Generalized cost‐effectiveness analysis for national‐level priority‐setting in the health sector. Cost Eff Resour Alloc. 2003;1(1):8.
Mungle T, Das N, Pal S, et al. Comparative treatment costs of risk‐stratified therapy for childhood acute lymphoblastic leukemia in India. Cancer Med. 2023;12(3):3499‐3508.
Pramesh CS, Badwe RA, Borthakur BB, et al. Delivery of affordable and equitable cancer care in India. Lancet Oncol. 2014;15(6):e223‐e233.
Ahuja S, Sharma J, Gupta S, et al. Patient tracking during treatment of children with cancer in India—an exploratory study. Cancer Rep. 2022;5(6):e1359.
Srinivasan A, Tiwari K, Scott JX, Ramachandran P, Ramakrishnan M. Impact of cancer support groups on childhood cancer treatment and abandonment in a private pediatric oncology centre. Indian J Palliat Care. 2015;21(1):68‐71.
Jatia S, Prasad M, Paradkar A, et al. Holistic support coupled with prospective tracking reduces abandonment in childhood cancers: a report from India. Pediatr Blood Cancer. 2019;66(6):e27716.
فهرسة مساهمة: Keywords: India; LMIC; childhood AML; cost‐effectiveness; sepsis; toxicity
تواريخ الأحداث: Date Created: 20240810 Latest Revision: 20240810
رمز التحديث: 20240812
DOI: 10.1002/pbc.31242
PMID: 39126354
قاعدة البيانات: MEDLINE
الوصف
تدمد:1545-5017
DOI:10.1002/pbc.31242