Reduced medical costs and hospital days when using oral arsenic plus ATRA as the first-line treatment of acute promyelocytic leukemia.

Abstract

We have demonstrated that oral arsenic (Realgar-Indigo naturalis formula, RIF) plus all-trans retinoic acid (ATRA) is not inferior to intravenous arsenic trioxide (ATO) plus ATRA as the first-line treatment of acute promyelocytic leukemia (APL). To compare the cost-effectiveness of oral and intravenous arsenic, we analyzed the results of 30 patients in each group involved in a randomized controlled trial at our center. The median total medical costs were $13,183.49 in the RIF group compared with $24136.98 in the ATO group (p<0.0001). This difference primarily resulted from the different costs of induction therapy (p=0.016) and maintenance treatment (p<0.0001). The length of hospitalization for the RIF group was significantly lower than that for the ATO group (24 vs. 31 days, p<0.0001) during induction therapy. During maintenance treatment, the estimated medical costs were $2047.14 for each patient in the RIF group treated at home compared with $11273.81 for each patient in the ATO group treated in an outpatient setting (p<0.0001). We conclude that oral RIF plus ATRA significantly reduced the medical costs and length of hospital stay during induction and remission therapy compared with ATO plus ATRA in APL patients.

• Authors: Hao Jiang, Gong-Wen Liang, Xiao-Jun Huang, Qian Jiang, Sheng Han, Lu-Wen Shi, Hong-Hu Zhu
• Journal: Leukemia research (Leuk Res) Vol. 39 Issue 12 Pg. 1319-24 (Dec 2015) ISSN: 1873-5835 [Electronic] England
• PMID: 26403986 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2015 Elsevier Ltd. All rights reserved.

Chemical References

• Arsenicals
• Oxides
• Tretinoin
• Arsenic Trioxide

Topics

• Adolescent
• Adult
• Antineoplastic Combined Chemotherapy Protocols (economics, therapeutic use)
• Arsenic Trioxide
• Arsenicals (administration & dosage, economics)
• China
• Cost Savings
• Cost-Benefit Analysis
• Direct Service Costs
• Female
• Health Care Costs
• Hospitals, University (economics)
• Humans
• Length of Stay (economics, statistics & numerical data)
• Leukemia, Promyelocytic, Acute (drug therapy, economics)
• Maintenance Chemotherapy (economics)
• Male
• Middle Aged
• Oxides (administration & dosage, economics)
• Randomized Controlled Trials as Topic
• Remission Induction
• Retrospective Studies
• Tretinoin (administration & dosage, economics)
• Young Adult