OBJECTIVES: Graft-versus-host disease (GvHD) presents a major challenge to successful allogeneic stem cell transplantation (aSCT). Extracorporeal photopheresis (ECP) is a promising alternative to standard immunosuppressive therapies but it was not available at the participating study centre in Belgium. A retrospective analysis was undertaken of resource use and treatment costs with available therapies in patients who developed steroid-refractory or steroid-dependent acute (aGvHD) or chronic GvHD (cGvHD) following aSCT.

METHODS: Data were collected on number, duration and cost of hospitalisations, GvHD-related diagnostic procedures, and treatment for the management of symptoms and complications of GvHD. A hypothetical date was identified (the index date; ID) at which clinicians would have referred patients to ECP had it been available. Costs were analysed prior to the potential referral for ECP and compared with those after referral.

RESULTS: The study group comprised 26 patients with aGvHD (n=17) or cGvHD (n=9), all eligible for ECP treatment had it been available. The costs of GvHD management at the centre were primarily driven by high inpatient hospitalisation costs. Average monthly inpatient cost was €2,687 per patient prior to the ID and €2,689 between the ID and the end of the study. Average monthly outpatient cost was €753 per patient prior to the ID and €542 between the ID and end of the analysis.

CONCLUSIONS: This analysis, undertaken in a small number of patients, suggests that the management of patients with GvHD following aSCT is associated with high healthcare burden in Belgium, primarily related to hospitalisations. A significant unmet need remains for effective GvHD therapies and options such as ECP should be considered. Accessibility to ECP is limited in Belgium and not reimbursed. A similar retrospective analysis is planned to confirm potential changes in healthcare utilisation and costs with ECP treatment.