Out-of-pocket costs analysis of ifosfamide, epirubicin, and etoposide (IEV) and etoposide, solu-medrol-methylprednisolone, high-dose ara-C-cytarabine, and platinol-cisplatin (ESHAP) regimens in the patients with relapsed and refractory lymphoma in Iran

This is an out-of-pocket costs analysis of ifosfamide, epirubicin, and etoposide (IEV) and etoposide, solu-medrol-methylprednisolone, high-dose ara-C-cytarabine, and platinol-cisplatin (ESHAP) drug regimens in treatment of lymphoma in Iran.
This cross-sectional study was conducted in Shiraz City. Data were collected using a data-collection form. The social perspective was used to collect cost data. Three types of costs were measured, medical direct costs, non-medical direct costs, and indirect costs.
65 patients were treated with these two methods; 27 patients were treated with IEV and 38 with ESHAP. Moreover, the mean direct cost in IEV and ESHAP regimens in 2014 were 1191.10 ± 610.74 and 1819.57 ± 789.73 United States dollars (USD), respectively. The difference was statistically significant (P In this study, costs in the IEV regimen were significantly lower than the ESHAP regimen. This was particularly caused by an earlier discharge of patients under IEV regimen; since these patients experienced a trend toward less neutropenia and, hence, had a trend toward fewer hospitalization days, the related cost was 3451.76 USD with savings of 6479.61 USD compared with the ESHAP regimen. Overall, most of patient’s income was spent on out-of-pocket costs for all expenditures incurred because of lymphoma.