Cost analysis of ganciclovir and foscarnet in recipients of allogeneic hematopoietic cell transplant with cytomegalovirus viremia

Healthcare Resource Use and Costs of Allogeneic Hematopoietic Stem Cell Transplantation Complications: A Scoping Review

Allogeneic hematopoietic stem cell transplant (allo-HSCT) is an expensive and resource intensive procedure. This study aims to review the literature pertaining to healthcare resource utilization (HRU) and costs associated with allo-HSCT complications. The review followed the Joanna Briggs Institute methodology for scoping reviews. The PubMed, EMBASE, and Health Business Elite were searched in addition to the grey literature. Eligibility criteria included studies that reported HRU and/or costs associated with adult (≥18 years) allo-HSCT. Studies were categorized according to complications of allo-HSCT including graft-versus-host disease (acute and chronic GVHD) and infections (fungal, cytomegalovirus, virus-associated hemorrhagic cystitis, and acute respiratory tract infection). Commonly reported HRU and cost measures were extracted, including those associated with the direct management of allo-HSCT complications and intensive care unit (ICU) admissions. Reported costs were standardized to 2022 United States Dollars. Patients who experienced GVHD or infection post-transplant had an overall greater HRU including higher rates of hospitalization, hospital readmission, ICU admission, and longer length of stay compared to those patients who did not. Patients with severe or refractory GVHD and/or infection following allo-HSCT required greater healthcare intervention. This scoping review synthesizes the current literature on HRU and costs associated with post allo-HSCT complications. Patients who experienced post allo-HSCT complications had higher HRU and incurred higher costs overall, noting the variability across studies in their clinical context, reporting of HRU, and cost measures.