| Methodologic: study design/data collection elements |
| Difficult to capture all societal costs |
| For studies with patient perspective: out-of pocket costs may vary based on insurance schemes and income levels |
| Heterogeneity between accounting methods and cost estimation among different institutions or even the same institution over time |
| Difficulty accounting for costs outside the hospital system, especially for long-term survivors resulting from fragmentation of care, unless using claims-based system |
| Estimation of costs related only to the transplant process in patients with multiple comorbidities that need medical management |
| Analysis and interpretative elements |
| Costs in the context of clinical trials may be inflated because of trial-specific requirements |
| Modeling-based methods for cost-effectiveness analysis rely on assumptions that may not reflect real-world decisions |
| Complexity of medical science and rapid pace of therapeutic innovation makes constant reevaluation of benefits and costs essential |
| Cost-effectiveness thresholds vary over time and from country to country |
| Methodologic: study design/data collection elements |
| Difficult to capture all societal costs |
| For studies with patient perspective: out-of pocket costs may vary based on insurance schemes and income levels |
| Heterogeneity between accounting methods and cost estimation among different institutions or even the same institution over time |
| Difficulty accounting for costs outside the hospital system, especially for long-term survivors resulting from fragmentation of care, unless using claims-based system |
| Estimation of costs related only to the transplant process in patients with multiple comorbidities that need medical management |
| Analysis and interpretative elements |
| Costs in the context of clinical trials may be inflated because of trial-specific requirements |
| Modeling-based methods for cost-effectiveness analysis rely on assumptions that may not reflect real-world decisions |
| Complexity of medical science and rapid pace of therapeutic innovation makes constant reevaluation of benefits and costs essential |
| Cost-effectiveness thresholds vary over time and from country to country |