THE TRUE COST OF BONE-MARROW TRANSPLANTATION

Bone marrow transplantation is an example of a highly technical therap y that offers hope to patients with bone marrow failure or various mal ignancies, Bone marrow transplantation is much more costly ''up-front' ' but perhaps not more costly long-term than alternative therapies. Al though economic analyses appear relatively simple, interpretation and use can be problematic, Several economic analyses have identified comp lications that occur frequently and affect the reported cost-effective ness of high-dose chemotherapy, Efforts to reduce the cost of bone mar row 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 shift ing of care to outpatient settings all have resulted in significant re ductions in duration of hospital stay, treatment-related mortality, an d costs, More studies of long-term outcomes are needed for transplant and nontransplant treatment options to guide present and future applic ations of this treatment option.