{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T14:47:31Z","timestamp":1782744451728,"version":"3.54.5"},"reference-count":37,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"6","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Glob Oncol"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>Childhood Hodgkin lymphoma comprising 40%-45% of pediatric lymphomas is curable with multimodal therapy, but optimal treatment access remains limited in many settings. The Adapted Resource and Implementation Application (ARIA) guidelines provide resource-stratified, evidence-based regimens to support equitable care delivery across diverse health systems. To inform implementation and global decision making, understanding cost implications across ARIA-defined clinical choices is critical.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We conducted a top-down microcosting analysis from a US payer perspective to evaluate costs across ARIA risk groups and resource-based strata. An ingredient-based framework was developed guided by ARIA and validated with expert input. Unit costs (2024 US dollars) were retrieved from Centers for Medicare &amp; Medicaid Services, IQVIA, and St Jude Children's Research Hospital. Costs were calculated for pretreatment, treatment, and 5-year follow-up phases across ARIA risk groups and strata (A-E). Essential services included core clinical care, while essential + recommended added advanced laboratories and imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Total per-patient costs ranged from $24,116 US dollars (USD) to $189,244 USD. Essential pretreatment costs were $8,783 USD versus $9,689 USD-$11,321 USD for essential + recommended. Treatment costs rose with risk level and resource strata: $6,285 USD-154,316 (essential) and $7,182 USD-168,875 (essential + recommended). Substituting vincristine with brentuximab vedotin increased chemotherapy costs from $2,510 USD to $147,118 USD across risk groups. Radiotherapy costs ranged from $7,304 USD to $19,355 USD. Follow-up costs were $9,048 USD, across strata.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>This first ARIA-informed cost analysis demonstrates how resource-driven clinical decisions shape cost with conventional treatment representing a fraction of regimens incorporating novel therapies. The proposed methodology provides a scalable blueprint for future costing across settings and cancer types to support adaptive Health Technology Assessment and guide investments toward equitable childhood cancer care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/go-26-00021","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T19:59:15Z","timestamp":1781121555000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Microcosting of Childhood Hodgkin Lymphoma Treatment Across Resource Levels Using the Adapted Resource and Implementation Application Guidelines in the US"],"prefix":"10.1200","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2019-9703","authenticated-orcid":true,"given":"Sahar","family":"Aliabadi","sequence":"first","affiliation":[{"name":"School of Public Health, University of Alberta, Edmonton, AB, Canada"},{"name":"Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8945-6917","authenticated-orcid":true,"given":"Priyadarshini","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Pathology, St Jude Children's Research Hospital, Memphis, TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4139-4160","authenticated-orcid":true,"suffix":"Jr.","given":"John T.","family":"Lucas","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, St Jude Children's Research Hospital, Memphis, TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meagan","family":"Norton","sequence":"additional","affiliation":[{"name":"Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer L.","family":"Pauley","sequence":"additional","affiliation":[{"name":"Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2333-4364","authenticated-orcid":true,"given":"Hannah E.","family":"Sauer","sequence":"additional","affiliation":[{"name":"Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose Miguel","family":"Martinez","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Alberta, Edmonton, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7717-8638","authenticated-orcid":true,"given":"Yutaka","family":"Yasui","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Alberta, Edmonton, AB, Canada"},{"name":"Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5282-7833","authenticated-orcid":true,"given":"Nickhill","family":"Bhakta","sequence":"additional","affiliation":[{"name":"Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6619-5291","authenticated-orcid":true,"given":"Nancy S.","family":"Bolous","sequence":"additional","affiliation":[{"name":"Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"e_1_3_8_2_2","volume-title":"Childhood Cancer","author":"World Health Organization","year":"2025","unstructured":"World Health Organization. Childhood Cancer. Geneva, Switzerland: World Health Organization, 2025"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.aaw4892"},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(20)30022-X"},{"key":"e_1_3_8_5_2","volume-title":"WHO and St. Jude to Dramatically Increase Global Access to Childhood Cancer Medicines","author":"World Health Organization","year":"2021","unstructured":"World Health Organization. WHO and St. Jude to Dramatically Increase Global Access to Childhood Cancer Medicines. Geneva, Switzerland: World Health Organization, 2021"},{"key":"e_1_3_8_6_2","first-page":"110","volume-title":"The ARIA Guide Hodgkin Lymphoma Adapted Management Guideline (AMG) Document (ver 1.4)","author":"The ARIA Guide Coordinating Center GRP, and Steering Committee, Department of Global Pediatric Medicine and St. Jude Global, St. Jude Children\u2019s Research Hospital, International Society of Paediatric Oncology (SIOP), Paediatric Radiation Oncology Society (PROS), International Society of Paediatric Surgical Oncology (IPSO), Childhood Cancer International (CCI)","year":"2024","unstructured":"The ARIA Guide Coordinating Center GRP, and Steering Committee, Department of Global Pediatric Medicine and St. Jude Global, St. Jude Children\u2019s Research Hospital, International Society of Paediatric Oncology (SIOP), Paediatric Radiation Oncology Society (PROS), International Society of Paediatric Surgical Oncology (IPSO), Childhood Cancer International (CCI). The ARIA Guide Hodgkin Lymphoma Adapted Management Guideline (AMG) Document (ver 1.4). Memphis, TN: St Jude Children\u2019s Research Hospital; 2024:110."},{"key":"e_1_3_8_7_2","volume-title":"Childhood Hodgkin Lymphoma Treatment (PDQ\u00ae)\u2014Health Professional Version","author":"National Cancer Institute","year":"2024","unstructured":"National Cancer Institute: Childhood Hodgkin Lymphoma Treatment (PDQ\u00ae)\u2014Health Professional Version, 2024"},{"key":"e_1_3_8_8_2","doi-asserted-by":"publisher","DOI":"10.4084\/MJHID.2024.078"},{"key":"e_1_3_8_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.24905"},{"key":"e_1_3_8_10_2","doi-asserted-by":"publisher","DOI":"10.1023\/A:1008200210674"},{"key":"e_1_3_8_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(197808)42:2<787::AID-CNCR2820420251>3.0.CO;2-4"},{"key":"e_1_3_8_12_2","doi-asserted-by":"publisher","DOI":"10.1080\/10428190802663205"},{"key":"e_1_3_8_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2022.101729"},{"key":"e_1_3_8_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10198-008-0101-x"},{"key":"e_1_3_8_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmg.2022.104672"},{"key":"e_1_3_8_16_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.18.00122"},{"key":"e_1_3_8_17_2","volume-title":"Centers for Medicare & Medicaid Services","author":"Centers for Medicare & Medicaid Services","year":"2025","unstructured":"Centers for Medicare & Medicaid Services. Baltimore, MD: Centers for Medicare & Medicaid Services, 2025. https:\/\/www.cms.gov\/"},{"key":"e_1_3_8_18_2","unstructured":"American Medical Association. CPT Overview and Code Approval. Chicago IL: American Medical Association 2025"},{"key":"e_1_3_8_19_2","volume-title":"Quarterly Addenda Updates","author":"Centers for Medicare & Medicaid Services","year":"2025","unstructured":"Centers for Medicare & Medicaid Services. Quarterly Addenda Updates. Baltimore, MD: Centers for Medicare & Medicaid Services, 2025. https:\/\/www.cms.gov\/medicare\/payment\/prospective-payment-systems\/hospital-outpatient-pps\/quarterly-addenda-updates"},{"key":"e_1_3_8_20_2","volume-title":"ASC Payment Rates\u2014Addenda","author":"Centers for Medicare & Medicaid Services","year":"2025","unstructured":"Centers for Medicare & Medicaid Services. ASC Payment Rates\u2014Addenda. Baltimore, MD: Centers for Medicare & Medicaid Services (CMS), 2025. https:\/\/www.cms.gov\/medicare\/payment\/prospective-payment-systems\/ambulatory-surgical-center-asc\/asc-payment-rates-addenda"},{"key":"e_1_3_8_21_2","volume-title":"FY 2026 IPPS Final Rule Home Page\u2014Tables 8A, 8B, and 8C","author":"Centers for Medicare & Medicaid Services","year":"2025","unstructured":"Centers for Medicare & Medicaid Services. FY 2026 IPPS Final Rule Home Page\u2014Tables 8A, 8B, and 8C. Baltimore, MD: Centers for Medicare & Medicaid Services (CMS), 2025. https:\/\/www.cms.gov\/medicare\/payment\/prospective-payment-systems\/acute-inpatient-pps\/fy-2026-ipps-final-rule-home-page#MAC"},{"key":"e_1_3_8_22_2","unstructured":"Agency for Heathcare Research and Quality. HCUP Cost-to-Charge Ratio (CCR) Files. Rockville MD: Agency for Healthcare Research and Quality 2025. https:\/\/hcup-us.ahrq.gov\/db\/ccr\/costtocharge.jsp"},{"key":"e_1_3_8_23_2","volume-title":"Overview of Local Audit Data Sourced for MIDAS, and Known Differences","author":"IQVIA: MIDAS\u00ae & National Audit Data Sources","year":"2019","unstructured":"IQVIA: MIDAS\u00ae & National Audit Data Sources. Overview of Local Audit Data Sourced for MIDAS, and Known Differences. Durham, NC: IQVIA, 2019. https:\/\/www.iqvia.com\/"},{"key":"e_1_3_8_24_2","volume-title":"Chemoglobe: Chemotherapy Cost Visualization Beta, Cost of Chemotherapy by Childhood Cancer Group and WHO region","author":"Global SJ","year":"2025","unstructured":"Global SJ. Chemoglobe: Chemotherapy Cost Visualization Beta, Cost of Chemotherapy by Childhood Cancer Group and WHO region. Memphis, TN: St Jude Children\u2019s Research Hospital, 2025"},{"key":"e_1_3_8_25_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198710223171717"},{"key":"e_1_3_8_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2025.06.3876"},{"key":"e_1_3_8_27_2","first-page":"155","article-title":"Cost of treating pediatric cancer at the butaro cancer center of excellence in Rwanda","volume":"4","author":"Neal C","year":"2018","unstructured":"Neal C, Rusangwa C, Borg R, et al: Cost of treating pediatric cancer at the butaro cancer center of excellence in Rwanda. J Glob Oncol, 4:155, 2018","journal-title":"J Glob Oncol"},{"key":"e_1_3_8_28_2","first-page":"10","article-title":"Estimation of chemotherapy costs applying the full protocol of children with acute lymphoblastic leukemia or Hodgkin's lymphoma: Case study","volume":"69","author":"Jasso-Guti\u00e9rrez L","year":"2012","unstructured":"Jasso-Guti\u00e9rrez L, Acosta ED, Rodriguez Ortega EE, et al: Estimation of chemotherapy costs applying the full protocol of children with acute lymphoblastic leukemia or Hodgkin's lymphoma: Case study. Bolet\u00edn M\u00e9dico Del Hosp Infantil de M\u00e9xico 69:10-21, 2012","journal-title":"Bolet\u00edn M\u00e9dico Del Hosp Infantil de M\u00e9xico"},{"key":"e_1_3_8_29_2","doi-asserted-by":"publisher","DOI":"10.2147\/CEOR.S395170"},{"key":"e_1_3_8_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2019.03.021"},{"key":"e_1_3_8_31_2","unstructured":"World Bank Group. GDP Deflator (Base Year Varies by Country)\u2014United States. Washington DC: World Bank Group 2025. https:\/\/data.worldbank.org\/indicator\/NY.GDP.DEFL.ZS?locations=US"},{"key":"e_1_3_8_32_2","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.11509"},{"key":"e_1_3_8_33_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2003.11.059"},{"key":"e_1_3_8_34_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2000.18.12.2435"},{"key":"e_1_3_8_35_2","volume-title":"Brentuximab Vedotin","author":"Wikipedia Contributors","year":"2025","unstructured":"Wikipedia Contributors. Brentuximab Vedotin. San Francisco, CA: Wikimedia Foundation, 2025. https:\/\/en.wikipedia.org\/wiki\/Brentuximab_vedotin"},{"key":"e_1_3_8_36_2","volume-title":"FDA Approves Brentuximab Vedotin in Combination with Chemotherapy for Pediatric Patients with Classical Hodgkin Lymphoma","author":"US Food and Drug Administration (FDA)","year":"2022","unstructured":"US Food and Drug Administration (FDA). FDA Approves Brentuximab Vedotin in Combination with Chemotherapy for Pediatric Patients with Classical Hodgkin Lymphoma. Silver Spring, MD: US Food and Drug Administration, 2022. https:\/\/www.fda.gov\/drugs\/resources-information-approved-drugs\/fda-approves-brentuximab-vedotin-combination-chemotherapy-pediatric-patients-classical-hodgkin"},{"key":"e_1_3_8_37_2","volume-title":"Hodgkin Lymphoma: Treatment Options","author":"Lymphoma Research Foundation","year":"2025","unstructured":"Lymphoma Research Foundation. Hodgkin Lymphoma: Treatment Options. New York, NY: Lymphoma Research Foundation, 2025. https:\/\/lymphoma.org\/understanding-lymphoma\/aboutlymphoma\/hl\/hlfdaupdates\/"},{"key":"e_1_3_8_38_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13561-024-00514-6"}],"container-title":["JCO Global Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/GO-26-00021","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T14:27:19Z","timestamp":1782743239000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/GO-26-00021"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":37,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1200\/GO-26-00021"],"URL":"https:\/\/doi.org\/10.1200\/go-26-00021","relation":{},"ISSN":["2687-8941"],"issn-type":[{"value":"2687-8941","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"2026-01-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-23","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e2600021"}}