Background

Allogeneic hematopoietic stem cell transplantation (HSCT) is increasingly used, but this treatment is complex and costly. As clinical outcomes of HSCT with matched unrelated donor (MUD) and haploidentical donors are similar, costs could influence donor choice.

Method

We retrospectively compared resource utilization and costs of HSCT using the three different donor types (matched related donor (MRD) (n=32), haploidentical related (n=30) and MUD (n=60)) within the first year after transplantation. Costs were analysed through a bottom up method. Non-parametric bootstrapping was applied to test for statistical differences in costs. Subgroup analyses were performed to identify predictors for costs.

Results

Cost pre-transplant for search and acquisition of the graft were significantly higher in MUD HSCT (€35,222) versus MRD and haploidentical HSCT (€15,356 and €16,097, respectively). The costs of haploidentical HSCT were the highest in the transplant phase. Main cost factors were inpatient days and medication. Overall, the costs for haploidentical and MUD HSCT were similar (€115,724 for MUD, €113,312 for haploidentical).

Conclusion

Our study suggests no difference in total transplantation costs between allogeneic HSCT using a MUD or a haploidentical donor. Since clinical outcomes seem similar as well, the choice of donor type might be based on availability, speed, and logistics.