BFM 2009 (Berlin, Frankfurt, Munich) Protocol Cost Analysis for Childhood Acute Lymphoblastic Leukemia (ALL): Preliminary Real-World Data From Brazil/LATAM/LMIC
Author(s)
ELIO TANAKA, Sr., MD1, ELIO TANAKA, Sr., MD2, ANA CLAUDIA Machado Marra, Biochemistry Pharmaceutical3, Ana Paula Prestes, Biochemistry Pharmaceutical3, Rafael Anciutti Bronislawski, Administrative3, Solane Picolotto Fernandes de Aguiar, Biochemistry Pharmaceutical4, Mara Albonei Dudeque Pianovski, MD5.
1MEDICAL AUDIT, TNK MEDICAL AUDIT INSTITUTION, CURITIBA, Brazil, 2TNK MEDICAL AUDIT INSTITUTION, CURITIBA, Brazil, 3RESEARCH, ERASTO GAERTNER HOSPITAL, CURITIBA , PR, Brazil, 4RESEARCH, ERASTINHO HOSPITAL, CURITIBA , PR, Brazil, 5HEAD, ERASTINHO HOSPITAL, CURITIBA , PR, Brazil.
1MEDICAL AUDIT, TNK MEDICAL AUDIT INSTITUTION, CURITIBA, Brazil, 2TNK MEDICAL AUDIT INSTITUTION, CURITIBA, Brazil, 3RESEARCH, ERASTO GAERTNER HOSPITAL, CURITIBA , PR, Brazil, 4RESEARCH, ERASTINHO HOSPITAL, CURITIBA , PR, Brazil, 5HEAD, ERASTINHO HOSPITAL, CURITIBA , PR, Brazil.
OBJECTIVES: The study was to analyze children and adolescents with B-cell lineage ALL using the BFM-2009 protocol treatment costs .
METHODS: Analyses were conducted by stratifying patients according to risk group ( standard => SR , intermediate => IR , and high risk => HR ), as defined by the protocol. 34 patients with B-cell lineage ALL from January 2018 to February 2023 included . Cost estimates were obtained using a micro-costing approach, with data collection on hospitalization days, laboratory and non-laboratory tests, devices and medications, medical consultations, surgical and outpatient procedures .
RESULTS: The total cost were 7.160 USD , 10.609 USD and 64.376 USD for the SR , IR or HR groups, respectively ( rate 1:5 ) . The most common complications were dyscrasias (anemia and thrombocytopenia) and febrile neutropenia. The HR group, presented more complications, more expensive therapy , but the values do not exceed those of antineoplastic treatment. One of the causes of the high cost are hospitalizations for chemotherapy during the consolidation. 40% of the overall cost of the protocol across all groups was allocated to the cost of hospital materials and medicines. The costs of hospitalization and exams represent 20% each of the total value of the treatment. This is, as far as it was possible to identify in the literature, the first Brazilian study to carry out a detailed cost survey of the BFM-2009 protocol in the treatment of B ALL in children and adolescents, using the microcosting approach.
CONCLUSIONS: The costs of HR group incurring the highest overall and complication-related costs. However, the costs of chemotherapy exceeded those of complications, mainly due to hospital chemotherapy during the consolidation phase. In all groups, materials and medicines accounted for the largest share of expenditures. Future research should assess actual spending on treatment and infrastructure to help guide policymakers.
METHODS: Analyses were conducted by stratifying patients according to risk group ( standard => SR , intermediate => IR , and high risk => HR ), as defined by the protocol. 34 patients with B-cell lineage ALL from January 2018 to February 2023 included . Cost estimates were obtained using a micro-costing approach, with data collection on hospitalization days, laboratory and non-laboratory tests, devices and medications, medical consultations, surgical and outpatient procedures .
RESULTS: The total cost were 7.160 USD , 10.609 USD and 64.376 USD for the SR , IR or HR groups, respectively ( rate 1:5 ) . The most common complications were dyscrasias (anemia and thrombocytopenia) and febrile neutropenia. The HR group, presented more complications, more expensive therapy , but the values do not exceed those of antineoplastic treatment. One of the causes of the high cost are hospitalizations for chemotherapy during the consolidation. 40% of the overall cost of the protocol across all groups was allocated to the cost of hospital materials and medicines. The costs of hospitalization and exams represent 20% each of the total value of the treatment. This is, as far as it was possible to identify in the literature, the first Brazilian study to carry out a detailed cost survey of the BFM-2009 protocol in the treatment of B ALL in children and adolescents, using the microcosting approach.
CONCLUSIONS: The costs of HR group incurring the highest overall and complication-related costs. However, the costs of chemotherapy exceeded those of complications, mainly due to hospital chemotherapy during the consolidation phase. In all groups, materials and medicines accounted for the largest share of expenditures. Future research should assess actual spending on treatment and infrastructure to help guide policymakers.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE72
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis, Cost/Cost of Illness/Resource Use Studies, Value of Information
Disease
Oncology, Pediatrics