Original Article

The Economic Burden of Acute Myeloid Leukemia in Iran

Abstract

Background: Cancer imposes a significant economic burden on the health system and society. Acute myeloid leukemia (AML) is the third deadliest leukemia and is one of the leading health problems worldwide. The present study aimed to estimate the economic burden of AML in Iran for 2020.

Methods: In this study, we estimated a prevalence-based on the cost-of-illness of the AML in Iran. A societal perspective was considered, in which the direct costs and productivity losses with the adoption of the human capital approach in the AML cases were estimated for 2020. Moreover, in the present study, several resources including national cancer registry reports, hospital records, occupational data, and interviews with experts were cited.

Results: Approximately 98% of patients with AML received induction therapy. The AML economic burden was $33,243,107.39. Indirect costs accounted for 60% (21,593,764.4$) of this amount, and direct medical costs and direct non-medical costs make up for 19% (6,359,380.88$) and 16% (5,289,962.11$) of this estimated economic burden, respectively

Conclusion: The economic burden of AML in Iran is very remarkable and due to the increasing prevalence of this disease, it is expected to increase gradually. Having insights into the costs associated with the disease provide an excellent opportunity for health policymakers and managers to effectively improve resource allocation.

1. Shallis RM, Wang R, Davidoff A, Ma X, Zeidan AM (2019). Epidemiology of acute myeloid leukemia: Recent progress and enduring challenges. Blood Rev, 36:70-87.
2. Key Statistics for Acute Myeloid Leukemia (AML): American Cancer Society; 2020 (Available from: https://www.cancer.org/cancer/acute-myeloid-leukemia/about/key-statistics.html.
3. Acute myeloid leukemia (AML): Leukemia and Lymphoma Society. 2020. (Available from: https://www.lls.org/research/acute-myeloid-leukemia-aml
4. Medeiros BC, Chan SM, Daver NG, Jonas BA, Pollyea DA (2019). Optimizing sur-vival outcomes with post-remission ther-apy in acute myeloid leukemia. Am J He-matol, 94(7): 803-811.
5. Larg A, Moss JR (2011). Cost-of-illness studies: a guide to critical evaluation. Pharmacoeconomics, 29(8):653-71.
6. Clabaugh G, Ward MM (2008). Cost-of-illness studies in the United States: a sys-tematic review of methodologies used for direct cost. Value Health, 11(1):13-21.
7. Linertová R, García-Pérez L, Gorostiza I (2017). Cost-of-Illness in Rare Diseases. Adv Exp Med Biol,1031:283-297.
8. World Health Organization. WHO guide to identifying the economic consequences of disease and injury. 2009. Available from: https://apps.who.int/iris/handle/10665/137037
9. Daroudi R, Akbari Sari A, Nahvijou A, Kalaghchi B, Najafi M, Zendehdel K (2015). The Economic Burden of Breast Cancer in Iran. Iran J Public Health, 44(9):1225-33.
10. De Kouchkovsky I, Abdul-Hay M (2016). Acute myeloid leukemia: a comprehensive review and 2016 update. Blood Cancer J,6(7): e441.
11. Estey EH (2018). Acute myeloid leukemia: 2019 update on risk-stratification and management. Am J Hematol, 93(10):1267-1291.
12. Estey EH (2014). Acute myeloid leukemia: 2014 update on risk-stratification and management. Am J Hematol, 89(11).1063–1081.
13. Houts PS, Lipton A, Harvey HA, et al (1984). Nonmedical costs to patients and their families associated with outpatient chemotherapy. Cancer, 53(11):2388-92.
14. Ministry of Cooperation, Labor and Social Welfare. Labor market information sys-tem 2019. Available from: https://www.mcls.gov.ir/en/home
15. World Health Organization. World Health Statistics 2019. Geneva: World Health Organization; 2019.
16. World Bank, International Comparison Program database (2020). PPP conver-sion factor, GDP. World Bank Open Data. https://www.worldbank.org/en/programs/icp. Accessed on 12 March 2020.
17. Bryant A L, Deal AM, Walton A, et al (2015). Use of ED and hospital services for patients with acute leukemia after in-duction therapy: one year follow-up. Leuk Res, 39(4): 406–410.
18. Zeidan AM, Mahmoud D, Kucmin-Bemelmans IT, et al (2016). Economic burden associated with acute myeloid leu-kemia treatment. Expert Rev Hematol, 9(1):79-89.
19. Tennvall GR, Persson U, Nilsson B (1994). The economic costs of acute myeloid leukemia in Sweden. Int J Technol Assess Health Care,10(4):683-94.
20. Lang K, Earle CC, Foster T, Dixon D, Van Gool R, Menzin J (2005). Trends in the treatment of acute myeloid leukemia in the elderly. Drugs Aging, 22(11):943-955.
21. Meyers J, Yu Y, Kaye JA, Davis KL (2013). Medicare fee-for-service enrollees with primary acute myeloid leukemia: an analy-sis of treatment patterns, survival, and healthcare resource utilization and costs. Appl Health Econ Health Policy, 11(3):275-86.
22. El-Zawahry HM, Zeeneldin AA, Samra MA, et al (2007). Cost and outcome of treat-ment of adults with acute myeloid leuke-mia at the National Cancer Institute-Egypt. J Egypt Natl Canc Inst, 19(2):106-113.
23. Uyl-de Groot CA, Gelderblom-den Hartog J, Huijgens PC, Willemze R, van Ineveld BM (2001). Costs of diagnosis, treatment, and follow up of patients with acute mye-loid leukemia in the Netherlands. J Hema-tother Stem Cell Res,10(1):187-92.
24. Stalfelt AM, Brodin H (1994). Costs over time in conventional treatment of acute myeloid leukaemia. A study exploring changes in treatment strategies over two decades. J Intern Med, 236(4):401-409.
25. Leunis A, Blommestein HM, Huijgens PC, Blijlevens NM, Jongen-Lavrencic M, Uyl-de Groot CA (2013). The costs of initial treatment for patients with acute myeloid leukemia in the Netherlands. Leuk Res,37(3):245-50.
26. Bell JA, Galaznik A, Farrelly E, et al (2018). Economic burden of elderly patients with acute myeloid leukemia treated in routine clinical care in the United States. Leuk Res, 71:27-33.
27. Hartunian NS, Smart CN, Thompson MS (1980). The incidence and economic costs of cancer, motor vehicle injuries, coronary heart disease, and stroke: a comparative analysis. Am J Public Health,70(12):1249-60.
28. Lindgren B (1981). Costs of illness in Swe-den 1964-1975. Lund: Liber, IHE, Insti-tutet for halso- och sjukvardsekonomi.
29. Sotak ML, Marin M, Coombs J, et al (2012). PSY19 burden of illness (BOI) of FLT3- mutated acute myeloid leukemia (AML).Value Heal, 15(4);101-102.
Files
IssueVol 51 No 11 (2022) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijph.v51i11.11178
Keywords
Acute myeloid leukemia Consolidation therapy Iran Economic burden

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Alipour V, Rad S, Nargesi S, Mezginejad F, Jahangiri R, Dolatshahi Z, Mousavi SA, Moshkani Z. The Economic Burden of Acute Myeloid Leukemia in Iran. Iran J Public Health. 2022;51(11):2599-2607.