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Wednesday, October 28, 2009

A Look at: Stem cell transplantation for secondary progressive multiple sclerosis

Bone Marrow Transplant. 2009 Oct 26. [Epub ahead of print]

Autologous haematopoietic stem cell transplantation for secondary progressive multiple sclerosis: an exploratory cost-effectiveness analysis.

Tappenden P, Saccardi R, Confavreux C, Sharrack B, Muraro PA, Mancardi GL, Kozak T, Farge-Bancel D, Madan J, Rafia R, Akehurst R, Snowden J.

Health Economics and Decision Science (HEDS), School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK.

Treatment options for secondary progressive multiple sclerosis (SPMS) are limited. Mitoxantrone is routinely used to stabilize disease progression; however, evolving evidence suggests clinical benefit from intensive treatment with autologous haematopoietic stem cell transplantation (HSCT).

Given differences in cost and outcomes, preliminary cost-effectiveness studies are warranted if this approach is to be developed for more widespread application in SPMS. We developed a decision-analytic Markov model to explore the potential cost-effectiveness of autologous HSCT versus mitoxantrone in SPMS, using patient-level data from registry sources.

The model evaluates the lifetime costs and health outcomes associated with disability progression and relapse. Sensitivity analyses were undertaken to examine the uncertainty surrounding cost-effectiveness outcomes. In the absence of randomised controlled trial (RCT) evidence, conditions for comparative analysis were not ideal. Under optimistic assumptions, HSCT is estimated to cost below pound3000 per quality adjusted life year gained.

However, when a strict 6-month sustained progression rule is adopted, HSCT may be less effective and more expensive than mitoxantrone.

The model results were sensitive to reducing procedural costs and HSCT-related mortality.

We conclude that HSCT could potentially achieve an acceptable level of cost-effectiveness. However, caution should be exercised as large, high-quality RCTs comparing HSCT versus mitoxantrone are necessary to validate these findings. Bone Marrow Transplantation advance online publication, 26 October 2009; doi:10.1038/bmt.2009.305.

PMID: 19855441 [PubMed - as supplied by publisher]

Source: PubMed

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2 comments:

Anonymous said...

I am SP and had SCT a few months ago. I have regained my balance and bowel control [mostly]. I would say that SCT was definitely cost effective for me.

Ray mumme said...

Yes it works and you will get results but it is expensive. Why not just release your own adult stem cells from your bone marrow as much as you want and let the body do what it was dsigned to do.

You can release 3.5 million for $1.40 and do 5 or 10 times a day, that 17 to 20 million ASC working to rebuild your body.
We Published Peer Review Studies to prove it. We have help 1000's of people with all kinds of serious conditions by triggering the release of their own adult stem cells. It is done with StemEnhance!!! the base product has been consumed safely for over 3decades. completely all natural. www.rmumme.stemtechbiz.com