This research aims to analyse the Cost-Effectiveness of Bone Marrow Transplant vis-a-vis the conventional or alternative therapy for Hematological Disorder under the Thai Social Security Scheme during 1997 – 2001 by focusing on three different perspectives: the provider, the patient, and the payer.. The results from the study indicates: (1) The cost-effectiveness of patient under going Bone Marrow Transplantation and expected to live 40 years longer will attribute greater cost to the payer than the patients and the providers. While the cost-effectiveness of patients who did not receive the Bone Marrow Transplantation will bear greater cost to the providers than to payers by about 30 percent. The cost-effectiveness of the patients also increased due to the increase in cost of the donors of the patient and the care expenses. (2) Incremental cost-effectiveness of patient who received Conventional Therapy treatment will bring about a cost increment of 66% from the provider’s view, 92% increment from the payer’s view, and 37% from the patient’s view per an increase of 1 life saved, number of years of life saved, and QALY’s. Regarding the sensitivity analysis on life expectancy, the ratio of the difference between the Bone Marrow Transplantation and the Conventional Therapy treatment will be smaller as patients aged. Medical experts gave opinion that patients who undergone the Bone Marrow Transplantation should live longer than the Conventional Therapy. This is apparently widening up the ratio of differences between two treatment methods. Currently, there is no confirmed evidence that the life expectancy for people undertaking Bone Marrow Transplantation or those receiving Conventional Therapy would be lengthened differently. Without any empirical evidence, the payer may need to consider more on the responsibility that the patient should bear as some co-payment or sharing of the excessive cost incurred. Though the cost of the Bone Marrow Transplantation is greater than the Conventional Therapy, there is an exception when the life expectancy after the treatment appears to meet the expectation of the experts, Bone Marrow Transplantation will provide greater advantages for in term of cost.

M.Econ จุฬาลงกรณ์มหาวิทยาลัย ปี 2546