Cost/benefit relationship in 46 cases of myelodysplastic syndrome (RAEB and RAEB-T): a quality assurance analysis in clinical haematology.

BACKGROUND: Myelodysplastic Syndromes (MDS) are common and severe haematologic diseases. Clinicians still have no standard therapies surely able to obtain a better result in the different MDS (RAEB and RAEB-t in particular). Moreover, the costs due to the specific drug, to its clinical complications and to the days spent in hospital can be influenced by the chosen therapeutic regime. There are no published studies regarding a cost-benefit relationship of the different drugs commonly used today for MDS patients. PATIENTS AND METHODS: This retrospective study refers to 46 patients with RAEB or RAEB-t, followed in our Division from 1986 up to December 1992. The authors reviewed specific therapies (ARA-C vs other drugs, in particular), the costs supported by the National Health Service and the effects of the same therapies in terms of survival. The results have been worked out by statistical analysis. RESULTS: Some interesting data are presented in this study: chemotherapy does not improve survival and causes higher costs; the length of stay in hospital is not influenced by using chemotherapy or not; RAEB patients cause as high costs as RAEB-t ones. CONCLUSIONS: Although the study regards only a limited number of cases, it shows that the therapeutic efforts made so far in order to improve MDS patients' prognosis cannot be considered satisfying and their social cost is very high. Our report can be a useful starting-point for a QA analysis concerning the rational use of new drugs such as growth factors and interleukins.