Cost effectiveness of prophylactic intravenous immune globulin in chronic lymphocytic leukemia

Article Abstract:

Patients with compromised immune systems are vulnerable to many types of infection. Some of this vulnerability stems from a reduction in the amount of circulating antibodies which react with, and protect against, common bacteria. It is possible to supplement the patient's own antibodies with antibodies that have been chemically purified from the pooled blood of thousands of donors; the immune globulins prepared in this way contain antibodies which react with virtually all common bacterial pathogens. Unfortunately, immune globulins prepared in this way are also extremely costly. A study was therefore undertaken to evaluate the cost effectiveness of intravenous immune globulin treatment for patients undergoing therapy for chronic lymphocytic leukemia (CLL). Research has recently shown that the use of intravenous immune globulins significantly reduces the number of bacterial infections suffered by patients with CLL. However, the treatment does not improve the survival of the patients, and therefore an analysis of the cost effectiveness of the treatment must take into consideration the quality of life and not merely its overall length. After calculating the likelihood of serious infections, moderate infections, and trivial infections, the gain in days of life of improved quality can be determined. This can then be compared with the cost of intravenous immune globulin. The average patient would require a dose costing $840. Considering the cost of administration, the cost per patient per dose rises to about $910. Approximately 17 doses per year are required. It was determined that on average, the treatment provides less than one day of improved life quality per year per patient. This implies that the cost of the treatment per quality-adjusted year of life gained is $6 million per patient. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Reports, Immunoglobulins, Cost (Economics), Costs (Economics), Chronic lymphocytic leukemia

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Symptoms and suffering at the end of life in children with cancer

Article Abstract:

Doctors must do a better job of providing palliative care for children with cancer. Researchers surveyed 103 parents whose child had died of cancer. According to the survey, 89% of the children suffered a lot in their last month of life. Most of the suffering was caused by pain, fatigue, or shortness of breath. Only 27% of the children who received treatment for pain were completely free of pain. Suffering from pain was more common in children whose doctors were not actively involved in providing end-of-life care.

Surveys, Palliative treatment, Palliative care, Cancer in children, Cancer pain, Childhood cancer

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What are the potential cost savings from legalizing physician-assisted suicide?

Article Abstract:

Legalizing physician-assisted suicide may not provide the cost savings that some people have predicted. Some people estimate that much of the money spent on health care is spent in the last few months of life on expensive technologies. Using data on the rate of physician-assisted suicide in the Netherlands, two researchers estimate that if 3% of dying patients choose physician-assisted suicide in the US, only $627 million in 1995 dollars would be saved. This is less than 0.07% of total health care costs in the US.

Analysis, Economic aspects, Assisted suicide, Medical care, Cost of, Health care costs

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