OBJECTIVES: To estimate cost of care for patients with relapsed/refractory AML from the perspective of the Colombian health system.

METHODS: We identified relevant healthcare resource utilization using literature and consultations with local clinical experts. Prices were obtained from the ISSS tariff manual 2001 and from the SISMED report. The costs were expressed in 2019 US dollars (1USD = 3,281COP). The resources used for relevant health states such as treatment, Hematopoietic Stem Cell Transplantation (HSCT), and adverse events were included. Differential costs were considered depending on disease status (Disease Free Survival (DFS), or post-event state) and whether they underwent HSCT. For patients who did not receive HSCT, the medical costs associated with outpatient visits, emergencies, hospitalizations, procedures, laboratories, and blood transfusions were considered. For DFS state with transplantation, only outpatient resources for post-transplant were included.

RESULTS: In average, the cost per month by each health state was $97 for DFS with HSCT, $2,156 for DFS without HSCT, and $1,905 for post-progression patients. In the two later states, blood product transfusions accounted for 70.5% to 79.9% of costs, hospitalization for 9.8% to 13.5% and emergency department visits for 0.05% to 2.9%. The average cost of drug acquisition and management was $1,997, HSCT $30,626 and adverse events $1,299. For the terminal care, a total of $4,769 was estimated.

CONCLUSIONS: Relapsed/refractory AML has a high impact on the health system. Although the transplantation is the main driver of costs, it guarantees the cure of most patients. That said, reducing the occurrence of hospitalization, keeping the disease under control and improving the chances of transplantation and the patient’s quality of life are critical factors to be considered among treatment alternatives.