OBJECTIVES: Acute Myeloid Leukaemia (AML) is a rare haematologic disease associated with high mortality. There is limited data regarding the costs associated with clinical management of patients in Spain. This study focused on ascertaining potential costs of managing a patient with AML in Spain.

METHODS: Literature review from biomedical databases and other grey literature sources was conducted followed by Delphi study, semi-structured, with two-round consultation with 17 haematologists. Findings were ratified in a face-to-face Advisory Board with 8 experts. Resource utilisation translated into Spanish unit costs.

RESULTS: Patients are referred to hospital haematologists from primary care centres, emergency units and other haematological services for diagnosis, with an average of 3 visits before confirmation. Accurate AML diagnosis requires the use of at least 4 diagnostic techniques, involving conventional and molecular testing. Most patients experience clinical manifestations before diagnostic confirmation (e.g. anaemia, fever and infections) incurring additional costs. Conventional treatment involves intensive chemotherapy cycles for both induction and consolidation, either alone or in combination with a stem cell transplant (curative treatment). The most common transplant used in Spanish hospitals is allogeneic, which includes intervention to a donor. The transplant procedure in combination with chemotherapy costs over 48.211€/patient on average. Additionally, salvage therapies are sometimes used when remission is not achieved. On average, patients experience 4 hospitalisations and 53 inpatient days. The average estimated overall cost of treating a patient with AML in Spain, taking into consideration diagnosis, treatment and transplantation is approximately 59,505€/patient/year.

CONCLUSIONS: The diagnosis and clinical management of AML patients in Spain incurs a high healthcare burden. Several departments from different centres can be involved in the patient flow, from stages prior to diagnosis until transplant completion. The main costs associated with AML treatment are related to care provided in the inpatient setting during intensive chemotherapy and transplant stages.