A REVIEW OF THE COSTS, COST-EFFECTIVENESS AND 3RD-PARTY CHARGES OF BONE-MARROW TRANSPLANTATION

In an era of health care reform, costs, cost-effectiveness and charges for health care are taking on a larger role in the decision to adopt a new therapy, Hospitals, health maintenance organizations, third-part y payers, doctors and patients all have an interest in the economic fa ctors of health care; however, not all new therapies or medications ha ve been analyzed. Bone marrow transplantation is one of the most expen sive cancer treatments, costing an average of $193,000 per patient; th erefore, many economic studies have focused on the costs of the therap y, However, it is important to note that these findings are not necess arily applicable to other diseases, Cost data are not static and even small changes in protocol can make a Large difference in costs. Also, cost data from outside the United States is not always applicable to t he United States system due to differences such as socialized medicine , workers' wages and pharmaceutical costs, Many economic analyses focu s on the hospitals' charges and extrapolate cost-effectiveness from th ese figures, yet the amount hospitals charge for services and products is not always relative to the costs. Therefore, third-party payer cos ts are also important in analyzing the cost-effectiveness of a procedu re. This article will review five signature papers which illustrate im portant issues to consider when trying to determine the costs and cost -effectiveness of;bone marrow transplants.