Treatment cost of Lymphoma in children in a Tertiary care hospital in Bangladesh

Background: Lymphoma is the third most common cancer in children. Hodgkin’s disease has the highest cure rate in childhood malignancies. Counseling regarding the cost of treatment to the parents is one of the most importantparts of the treatment. But as there is no published article or data available in our country regarding the actualtreatment cost of the disease, it becomes very difficult for the Paediatric Haematologists and Paediatricians to givethe exact idea to the parents about the treatment cost. Objective: The study aimed to ascertain the treatment cost ofHodgkin disease (HD) and Non-Hodgkin lymphoma (NHL), which would be a guideline about the treatment costof Lymphoma to the healthcare provider and parents. Methodology: It was a cross-sectional observational studydone in the Paediatric Hematology and Oncology Department of Bangladesh Medical University (former BSMMU)during May 2010 – September 2010. Treatment cost was assessed by analyzing 20 patients who were diagnosed caseof Lymphoma. Among them, 6 patients were diagnosed case of H.D. and 14 were diagnosed case of NHL. Result:The approximate direct treatment cost has been found for Non-Hodgkin Lymphoma in FAB/ LMB 96 protocol (TheFAB/LMB 96 protocol is a chemotherapy regimen used internationally for treating pediatric B-cell non-Hodgkinlymphoma (NHL), including Burkitt lymphoma) BDT 180,000 over 8 months and in the BFM-NHL 90 protocol (The BFM-NHL 90 protocol is a chemotherapy regimen developed by the Berlin-Frankfurt-Münster (BFM) groupfor treating non-Hodgkin’s lymphoma (NHL) in children and adolescents.) BDT 298,000 over 26 months. Whilethe treatment cost of Hodgkin disease has been found in Hybrid protocol BDT 102,000 over 6 months and in theABVD protocol (ABVD is a chemotherapy regimen used in the first-line treatment of Hodgkin lymphoma whereAdriamycin, Bleomycin, Vinblastine and Dacarbazine are used) BDT 48,500 over 6 months. In case of complicationslike Septicemia, additional treatment cost comes around BDT 28,258 for each episode of complication. Conclusion:The treatment cost appeared burdensome for low-income people of Bangladesh. The main cost for the treatment ofLymphoma is for Chemotherapy and Investigation. Studies abroad showed similar observations. So, to reduce theburden of cost, Unnecessary investigations should be avoided and policymakers should emphasize reducing the costof Chemotherapy in Bangladesh.