High-dose chemotherapy (HDC) with autologous peripheral blood stem cell (PBSC) support is a common but expensive treatment for various hematological malignancies. A prospective cost analysis of evaluation/mobilization and the HDC + PBSC phase for patients with multiple myeloma was performed. Eleven consecutive patients at the National University Hospital Oslo, taking part in a Nordic treatment protocol, were included in the analysis during the period from May 1999 to December 2000. Clinical and resource use data were obtained prospectively on a daily basis registration and from patient records.The total cost for the evaluation/mobilization and the HDC + PBSC phase varied from 22,999 US dollars to 61,722 US dollars (mean 38,186 US dollars; median 30,569 US dollars). The mean length of hospital stay for the evaluation/mobilization phase was 8 days (range 4-17 days) and for the HDC + PBSC phase 19 days (range 14-29 days). A statistically significant correlation was found between the length of hospital stay and hospital costs for both phases (P
High-dose therapy with autologous blood progenitor cell support is now routinely used for patients with certain malignant lymphomas and multiple myeloma. We performed a prospective cost analysis of the mobilization, harvesting and cryopreservation phases and the high-dose therapy with stem cell reinfusion and hospitalization phases. In total, 40 consecutive patients were studied at four different university hospitals between 1999 and 2001. Data on direct costs were obtained on a daily basis. Data on indirect costs were allocated to the specific patient based on estimates of relevant department costs (ie the service department's costs), and by means of predefined allocation keys. All cost data were calculated at 2001 prices. The mean total costs for the two phases were US$ 32,160 (range US$ 19,092-50,550). The mean total length of hospital stay for two phases was 31 days (range 27-37). A large part of the actual cost in the harvest phase was attributed to stem cell mobilization, including growth factors, harvesting and cryopreservation. In the high-dose chemotherapy phase, the most significant part of the costs was nursing staff. Average total costs were considerably higher than actual DRG-based reimbursement from the government, indicating that the treatment of these patients was heavily subsidized by the basic hospital grants.