With Health Insurance: Copays + 10%-50% Coinsurance
Without Health Insurance: $35,000-$800,000+
A bone marrow transplant[1] , or stem cell transplant, is a procedure in which damaged bone marrow is replaced with healthy bone marrow stem cells. According to the Mayo Clinic[2] , it may be recommended for patients with certain types of cancer, such as leukemia, to restore stem cells destroyed by chemotherapy and/or radiation therapy, or for patients with sickle cell anemia or other blood diseases.
Typical costs:
For patients covered by health insurance, out-of-pocket costs for a bone marrow transplant typically consist of doctor visit, lab and prescription drug copays as well as coinsurance of 10%-50% for surgery and other procedures, which can easily reach the yearly out-of-pocket maximum. According to the Abramson Cancer Center[3] at the University of Pennsylvania, most health insurance plans cover all or part of the total cost, which includes preliminary testing, the collection and delivery of stem cells, the surgery itself and post-operative recovery costs. Costs can vary depending on region and hospital.
The total costs of a stem cell transplant are typically $350,000-$800,000, depending on whether the procedure is autologous, meaning some of the patient's own marrow or stem cells are used, or allogeneic, meaning cells are harvested from a donor. Allogeneic transplants are associated with increased cost, because, among other things, donors will need to be tested, placed under general anesthesia and admitted to an operating room so that bone marrow can be collected. A 2011 report[4] on the cost of organ and tissue transplants by the actuarial and consulting firm Milliman found an allogeneic bone marrow transplant typically costs $805,400 total. The report estimates the total cost for an autologous transplant to be $363,800.
A 2012 study[5] that examined the overall costs of pediatric stem cell transplantation including donor search and costs during the first year post-transplantation found the overall median cost to be $175,815, with a wide range, of $35,000-$780,000. Increased costs were significantly associated with age, use of donors other than matched siblings and advanced disease.
According to the Mayo Clinic[6] , after a transplant patient undergoes a series of tests and procedures to assess overall health and to ensure that a patient is physically ready for the transplant, a surgeon or radiologist will implant an intravenous catheter[7] in the chest. The catheter typically remains in place for the duration of treatment, and serves as the central line though which doctors will infuse transplanted stem cells, medications and blood products.
Following pre-transplant tests and procedures, the patient will begin a process known as conditioning, in which they will undergo chemotherapy, or radiation therapy to destroy cancer cells and suppress the immune system so that the body won't reject the transplanted stem cells. After several days of chemotherapy and/or radiation therapy the stem cells will be infused. Infusion typically takes one to five hours.
Post-surgery, a patient will need to take blood tests and other tests so that their condition can be monitored.
Additional costs:
According to The Dana-Farber/Brigham and Women's Cancer Center[8] at Brigham and Women's Hospital in Boston, personal expenses associated with bone marrow transplants, such as food and lodging expenses incurred when a patient and his or her family moves to be closer to a transplant center, are not covered by insurance.
Discounts:
Many hospitals offer discounts of 30% of more to uninsured/cash-paying patients. At St. Joseph Hospital[9] in Orange, CA, for example, patients without health insurance may qualify for a 45% discount off billed charges. The hospital also offers an additional 10% discount if payment is made within 10 days of the patient receiving the bill.
Under the federal government's Hill-Burton program[10] low-income patients may qualify for free or low-cost services.
Shopping for a bone marrow transplant:
The United Network for Organ Sharing, the non-profit organization that manages the nation's organ transplant system, offers a list of common funding sources[11] to help patients with the costs of transplants.
The nonprofit National Bone Marrow Transplant Link offers a resources and support guide[12] for bone marrow transplant patients.
Material on this page is for informational purposes only and should not be construed as medical advice. Always consult your physician or pharmacist regarding medications or medical procedures.
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