Costs of diagnosis, treatment, and follow up of patients with acute myeloid leukemia in the Netherlands

The aim of the study was to calculate the costs in various places of acute myeloid leukemia (AML). Patients less than 65 years old, who were treated f or newly diagnosed AML were included. The cost analysis distinguished betwe en diagnosis, treatment, follow-up (maximum of 2 years), and treatment of r elapse. The treatment period was divided into remission induction and conso lidation treatment, harvest of bone marrow (BM) or peripheral blood stem ce lls, and transplantation. The costs of diagnosis amounted to $3,167 (1995 U S$). Remission-induction treatments cost on average $46,387 and harvest of bone marrow or peripheral blood stem cells costs $6,491. The costs of the t ransplantation varied between $25,531 and $44,087. Costs of follow-up amoun ted to $4,167. Relapse treatment, mainly consisting of reinduction therapy, costs on average $24,338. The total average weighted costs of AML patients amounted to $104,386. Treating AML patients is very expensive, and major r eductions in costs are not expected in the next future. Considering efficac y and effectiveness, it seemed that choices based on costs could be made be tween several consolidation techniques and between a specific consolidation technique and/or palliative treatment.