Cost-effectiveness analysis of blood cell separators in allogeneic hematopoietic stem cell transplantation: a perspective from the Chinese healthcare system.

[BACKGROUND] Allogeneic hematopoietic stem cell transplantation (HSCT) is essential for the long-term survival of acute leukemia (AL) patients. Peripheral blood stem cell transplantation has become the preferred method due to its lower invasiveness and convenience. The blood cell separator is key for hematopoietic progenitor cell collection, with CD34+ cell collection efficiency (CE) influencing transplant outcomes and healthcare costs. This study compares the cost-effectiveness of two devices, Spectra Optia and COM.TEC apheresis system, to assess their impact on CD34+ cell CE in HSCT.

[METHODS] A decision tree-Markov model was constructed from the perspective of the healthcare system to simulate the 5-year outcomes of 10,000 acute leukemia patients experiencing allogeneic stem cell transplantation. Resource cost differences between two devices were analyzed under two scenarios: minimizing resource consumption (scenario 1) and maximizing CD34+ cell volume (scenario 2). Cost-effectiveness analysis was undertaken combining quality-adjusted life years (QALYs) and total medical costs, with incremental net monetary benefit calculated at predefined willingness-to-pay thresholds.

[RESULTS] Compared to COM.TEC, Spectra Optia reduced apheresis times by 1-6 percent and improved the rate of engraftment success by 0.23 percent to 1.82 percent. In scenario 1, the net benefit per patient ranged from $634.85 to $1,260.43, and in scenario 2, the net benefit per patient ranged from $169.62 to $256.65.

[CONCLUSION] Higher CE of the apheresis system optimizes both healthcare resource consumption and clinical outcomes. In the analysis considering the device price, Spectra Optia achieved cost-effectiveness dominance over COM.TEC at a surgical volume exceeding 121 cases per device.