Micro-costing analysis reveals pediatric Hodgkin lymphoma treatment costs across resource settings

Although survival for many childhood cancers has improved, children in resource-limited settings often lack access to the care and treatment needed to achieve those outcomes. The Adapted Resource and Implementation Application (ARIA) guide brings together global clinical experts to develop consensus-based treatment guidelines tailored to varying resource levels and risk groups, helping guide care where standard recommendations may not be feasible. Using the ARIA guideline for pediatric Hodgkin lymphoma, researchers led by Nancy Bolous, MD, MA, MSc, Department of Global Pediatric Medicine, developed a micro-costing framework that identified key treatment cost drivers and demonstrated a scalable approach that can be adapted across global healthcare settings.

The researchers modeled costs across ARIA resource-based strata to evaluate how treatment intensity and resource availability affect costs. They found that costs increased with treatment intensity and resource availability, ranging from about $24,000 per low-risk patient in the most resource-limited setting to $189,000 per high-risk patient in the highest-resource setting. Introducing the novel immunotherapy agent brentuximab vedotin substantially increased treatment costs approximately four- to ninefold, demonstrating the impact that newer therapies can have on overall costs. The findings were published in JCO Global Oncology.

“What excited me most was realizing we’re helping build evidence in an area where very little existed,” said first author Sahar Aliabadi, MSc, Department of Global Pediatric Medicine. “Without reliable cost data, it’s difficult for health systems to plan, prioritize and understand the resources needed to expand childhood cancer care.”

Beyond Hodgkin lymphoma, this framework is scalable to other childhood cancers as additional ARIA guidelines are developed, with future work incorporating partner cost data and additional components of the patient journey, including survivorship. “This publication is proof of concept for a broader effort to estimate the cost of delivering pediatric cancer care across diverse health systems,” said Bolous. “We look forward to building the evidence needed to help institutions around the world make more informed decisions about planning and investment in childhood cancer care.” 

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