Economics, health care systems and utilization of haematopoietic stem cell transplants in Europe.

Transplantation of haematopoietic stem cells from blood or bone marrow (HSCT) has seen rapid expansion. Increased costs and quality concerns present a challenge for health care providers. Information on factors influencing HSCT utilization is necessary. Data on 113 827 patients (37 761 allogeneic HSCT and 76 066 autologous HSCT), collected from 580 centres in 35 European countries between 1990 and 1999, were used. Economic factors, e.g. gross national product per capita, health care expenditure per capita and type of health care system were correlated with transplant rates (numbers of HSCT per 10 million inhabitants), team density (numbers of transplant teams per 10 million inhabitants) and increase in transplant numbers for each country. Annual numbers of HSCT increased in all European countries from 4234 in 1990 to 18 720 in 1999 irrespective of health care system. Economic strength and team density were the main determinants for transplant rate. This report reflects changes over the last decade and current status of HSCT in Europe. Economic strength, team density and hitherto unknown factors influence dissemination of the technology within Europe. These data provide a basis for health care planning, regulatory aspects and future research.