Resources

Resource Guide for Bone Marrow/Stem Cell Transplant
Friends Helping Friends

Costs

Understandably, the prospect of a transplant is stressful enough without worrying about finances too. But, the reality is that transplants are costly. Aside from medical costs, there may be additional out-of-pocket expenses. The financial burden on a family may become difficult if advanced planning is neglected. If you can anticipate expenses, you may plan for how they will be met. A preliminary list of expenses, other than those covered by insurance, might include:

• Lodging for follow-up care
• Follow-up office visits
• Home care, house cleaning following transplant
• Childcare
• Prescriptions
• Transportation and parking
• Telephone costs
• Over-the-counter medications and related supplies

If your transplant requires that you must search for a related or unrelated donor, expect to incur the following kinds of expenses:

• Donor search fees: A preliminary search of donor and cord blood registries is done free of charge by your doctor or SCT coordinator. Charges will begin when donors or cord blood units are tested. Two donor/cord blood unit registries in the U.S. are the National Marrow Donor Program (NMDP) and the Caitlin Raymond International Registry. Several other registries also exist (see Resource Listing).
• Your transplant center will assist you in determining if your insurance will cover the testing of donors. If you don’t have this coverage, you’ll be told of your financial responsibility. It may range from $10,000 to $25,000.
• Compatibility testing: Once a potential donor is identified, additional testing will be performed. Prices for these tests vary. Some centers require advance payment to cover these compatibility tests. Frequently more than one test is done. Unused portions of this initial fee are typically refunded or transferred to another of your patient accounts. These fees may or may not be reimbursed by insurance or government agencies.
• Donor typing of family and friends: There is a fee for each test done. This is due to the cost of lab work. Siblings are tested first and then other family members may wish to be tested. Insurance companies will generally cover testing of siblings, parents and children but not additional family members.

Stem cell harvest and donor expenses: The cost of the actual collection of cells from the donor, his/her medical tests, and possible travel expenses may be high. Usually there is a fixed fee for the collection and delivery of stem cells. The average rate is about $3,500–$5,000 if it’s a related donor. The average rate for an unrelated donor is $15,000–$50,000. Donors are not paid for any part of their stem cell donation. All of their medical and traveling expenses are covered by the patient’s insurance so that there are no costs to the donor.

The actual transplant: The procedure is expensive. Insurance companies vary widely on coverage. It is possible that much of your transplant, if not the entire cost, will be covered. Call your insurer to check on your coverage or have your transplant center make the contact. If your insurer refuses to cover expenses, be persistent and consider speaking with legal counsel or someone with expertise in the insurance field (see Resource Listing).

Post-transplant: It’s difficult to predict your expenses after the transplant. Much will depend on your recovery time, which may range from six months to a year. Your insurance company will probably cover testing and may also cover follow-up visits. However, there are many out-of-pocket expenses. Medications can be very costly, especially if you do not have prescription coverage. Ask about your coverage prior to transplant.

Costs may vary depending on your treatment center. Although the center may not be able to quote you an exact dollar amount for your transplant, do request a general estimate for what you can expect to pay. This is especially important if your insurance coverage is limited.

In general, transplant costs have declined over the years. This is due, in part, to the increased use of outpatient care. The rise in the number of autologous stem cell transplants, where donor expenses may be eliminated, is another cost reduction factor. An autologous transplant may range from $50,000 to $100,000 depending on the circumstances. An allogeneic transplant may range from $150,000 to $200,000 (see Insurance).

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