Health care utilisation and costs associated with different treatment protocols for newly diagnosed childhood acute lymphoblastic leukaemia: A population-based study in Ontario, Canada

Although different treatment protocols for childhood acute lymphoblastic leukaemia (ALL) all achieve high cure rates, their health care utilisation and costs have not been rigorously compared. Disease, treatment, and outcome data were chart abstracted for all children with ALL in Ontario, Canada, di...

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Bibliographic Details
Published in:European journal of cancer (1990) 2021-07, Vol.151, p.126-135
Main Authors: Gupta, Sumit, Sutradhar, Rinku, Li, Qing, Athale, Uma, Bassal, Mylene, Breakey, Vicky, Gibson, Paul J., Patel, Serina, Silva, Mariana, Zabih, Veda, Pechlivanoglou, Petros, Pole, Jason D., Mittmann, Nicole
Format: Article
Language:English
Subjects:
Acute lymphoblastic leukaemia
Acute lymphoblastic leukemia
Algorithms
Chemotherapy
Children
Confidence intervals
Cost
Cost analysis
Costs
Emergency medical care
Emergency medical services
Health care
Health care utilization
Health economics
Health services
Health services research
Health services utilization
Intravenous administration
Leukemia
Paediatric
Patients
Population based
Population studies
Population-based studies
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Summary:Although different treatment protocols for childhood acute lymphoblastic leukaemia (ALL) all achieve high cure rates, their health care utilisation and costs have not been rigorously compared. Disease, treatment, and outcome data were chart abstracted for all children with ALL in Ontario, Canada, diagnosed 2002–2012. Linkage to population-based databases identified health care utilisation. Utilisation-associated costs were determined through validated algorithms. Chemotherapy-associated costs were calculated separately. Health care utilisation and costs were compared between patients receiving Children's Oncology Group (COG) versus Dana-Farber Cancer Institute (DFCI)-based treatment. Of 802 patients, 146 (18.2%) were treated on DFCI-based protocols. COG patients experienced significantly higher rates of emergency department (ED) visits (adjusted rate ratio [aRR]: 1.3, 95% confidence interval [CI]: 1.1–1.5; p = 0·01), whereas outpatient visit rates were 60% higher among DFCI patients (aRR: 1.6, 95% CI: 1.5–1.7, p 
ISSN:0959-8049
1879-0852
DOI:10.1016/j.ejca.2021.04.006