Bone marrow (stem cell) transplantation: funding in 2026, documents and treatment abroad

What is a bone marrow transplant, in simple terms?

Bone marrow produces all blood cells: red blood cells, white blood cells and platelets. When this system has been damaged by disease or intensive treatment, doctors replace it with healthy stem (haematopoietic) cells. The cells are collected from the bone marrow or, more often, from peripheral blood after special preparation. The transplant itself is not like a surgical operation: the cells are given into a vein, much like a transfusion. It is preceded by "conditioning", that is, high-dose chemotherapy, sometimes combined with radiotherapy, and afterwards the immune system needs weeks and months to recover.

The Georgian programmes name three types, and the tariff differs by type. In an autologous transplant, the patient receives back their own cells, collected in advance. In an allogeneic transplant, the cells come from another person, a related or unrelated donor whose tissue compatibility (HLA) has been confirmed in the laboratory. A haploidentical transplant is a form of allogeneic transplant in which the donor is a half-matched family member, often a parent or child.

What does the state programme cover in 2026?

In the 2026 State Healthcare Programmes, bone marrow transplantation is in Annex 14, under the programme "Organ Transplantation" (programme code 27 03 03 03). The programme is implemented by the National Health Agency. Of its budget of GEL 12 million, GEL 10 million goes to the bone marrow component, and the rest to liver transplantation.

The beneficiary is a Georgian citizen who needs a transplant and has one of the listed diagnoses: acute leukaemia (including lymphoid and myeloid), chronic myeloid leukaemia, juvenile myelomonocytic leukaemia, Hodgkin and non-Hodgkin lymphoma, myelodysplastic syndrome, aplastic anaemia, histiocytosis, thalassaemia or multiple myeloma. Excluded from the state programme are those who have the same service funded by the programme of Tbilisi or of the Autonomous Republic of Adjara.

The tariffs are taken from Annex 14.1 to Government Resolution No. 655 of 2025 and Annex 4 to Tbilisi City Assembly Resolution No. 6-18 of 2025. Both programmes cover the actual cost in full within the tariff; whatever exceeds the tariff, the programme does not pay.

Three rules determine how funding works in practice. First, the service is funded through a physical voucher or an approval letter issued by the Agency. Second, each service is funded for a beneficiary only once per budget year. Third, the transplant itself is not part of the Universal Healthcare package: Universal Healthcare lists organ transplantation among the excluded services. The logic of that programme is explained in the Universal Healthcare guide.

What applies to people registered in Tbilisi and Adjara?

Tbilisi City Hall's Healthcare and Social Services Department runs the sub-programme "Transplantation" (code 06 01 13). The beneficiary must be a Georgian citizen who has been continuously registered in Tbilisi for the last year before applying to City Hall; someone who registered in Tbilisi for the first time and had not previously been registered in another municipality is also eligible. Tbilisi's list of diagnoses is broader than the state list: it additionally includes seminoma, neuroblastoma, Ewing sarcoma, rhabdomyosarcoma, ependymoma, retinoblastoma and Wilms tumour.

The Tbilisi rules contain one restriction that directly affects plans for treatment abroad: an autologous transplant is funded only with a provider registered in Georgia, unless a medical board made up of representatives of the providers taking part in the sub-programme confirms that the service is necessary abroad. The rules contain no such condition for allogeneic and haploidentical transplants. Tbilisi's other healthcare sub-programmes are reviewed in the municipal assistance guide.

For residents of the Autonomous Republic of Adjara, the state programme refers directly to the Republic's own programme. Check its 2026 conditions, tariffs and implementing body with the Adjara Ministry of Health and Social Protection before you start collecting documents.

How to apply to the Agency: step by step

The state programme does not treat a transplant as a single application. Each stage, chemotherapy, tests and transplant, is funded separately and starts with a separate request, although a document already submitted is not requested a second time.

1. The medical board opinion

   At least three certified doctors of the relevant specialty, from different clinics, must confirm the need for high-dose chemotherapy and then for the transplant. If the patient is already abroad and such an opinion cannot be obtained, the Agency itself requests an opinion from at least two certified doctors, who may include a doctor from the foreign clinic.

2. Basic documents

   The application must include a copy of the patient's ID card or passport, and for an internally displaced person also the status document; for a minor, the birth certificate and a copy of the ID of a parent or legal representative; Form No. IV-100/a, with the diagnosis, interventions and tests given as ICD-10 codes; and a document showing that the patient is registered outside Tbilisi and Adjara.

3. An invoice for each stage

   The provider clinic issues an invoice confirming the cost of each service. At the transplant stage, the clinic also states the patient's condition, which tests have been carried out and when the preparatory period can begin.

4. Voucher or approval letter

   Under the general rules of the programmes, the Agency must recognise the beneficiary and issue the voucher or approval letter within 10 working days of the application, or inform you in writing of what is holding the case up. You hand the voucher to the clinic, which is then reimbursed by the Agency within the tariff.

The Agency's director has the power to set additional administrative conditions by their own act, so check the application form and the submission channel with the Agency's hotline before applying. The requirements for completing Form 100 correctly are described in the Form 100 guide, and if the Agency refuses you, the action plan is in the guide to appealing a refusal.

When do families go abroad for a transplant?

The decision to go abroad is usually driven by the medical team's recommendation: for example, when the required type of transplant cannot be performed at the local centre at that point, when finding an unrelated donor and transporting the cells requires the involvement of a foreign centre, or when the family wants a second opinion. Families often compare centres in Israel, Turkey, Germany and Spain; we have a separate guide for each: Israel, Turkey and Germany.

What the voucher rule means for a foreign clinic

The state programme also funds bone marrow transplants performed abroad. If the foreign facility refuses in writing to work with a voucher or approval letter, the Agency may pay on the basis of an invoice submitted by the family in advance. Two practical conclusions follow: you need the clinic's refusal in writing, and the invoice before treatment, broken down by stage. The tariff stays the same, so if the clinic's price exceeds it, the difference falls to the family.

What a foreign centre asks for in advance

• the discharge summary and the results confirming the diagnosis: bone marrow biopsy, immunophenotyping, cytogenetic and molecular tests;
• a detailed history of treatment already given, with chemotherapy courses and the response;
• HLA typing results for the patient and possible related donors, if it was done in Georgia;
• CT or PET scan reports and, on request, the images themselves on disc;
• for a related donor, documents proving kinship and the donor's own travel documents.

For a child there is also a second route: treatment of cancer patients under 18 at foreign partner clinics of the Solidarity Fund is funded by decision of the referral commission. Which route is better for a specific diagnosis, the guide to funding a child's treatment will help you work out, and our clinic search service can take on choosing centres and the correspondence.

Which documents need translating and when is an apostille needed?

For a local programme the documents are in Georgian, while for a foreign centre they are usually in English or the country's language. A haematology package is terminologically complex: laboratory units, markers and the names of treatment protocols must correspond exactly to the original in the translation. We translate Form 100 through our Form 100 translation service, the discharge summary following the procedure on the discharge summary translation page, and biopsy and laboratory results as part of test results translation.

In the other direction, a foreign invoice must be translated into Georgian for the Agency. It needs to be broken down by stage so that each stage can be compared with the corresponding programme tariff; documents of this type are covered by financial documents translation.

A medical document does not automatically need an apostille; it is required only by an authority or court of the receiving country, for example to prove kinship. A document from a medical facility, including a private one, can be apostilled directly in Georgia, and the Apostille or legalisation? tool shows you what each country requires. The full general checklist is in the guide to documents for treatment abroad.

Which costs stay with the family, even if the programme pays?

The tariff covers the medical episode, not the family's entire budget during the transplant period. When planning, split the costs into five groups so that you can find a source for each in advance:

1. The difference between the tariff and the clinic's price. This becomes the largest item abroad, where the price often exceeds the Georgian tariff.
2. Finding an unrelated donor. At some centres, the registry search and transport of the cells appear on the invoice as a separate line; ask whether it is included in the transplant price.
3. Travel and accommodation. After the transplant, the patient, the companion and, where relevant, the donor often have to stay near the clinic for several weeks.
4. Readmission. A complication that develops after the tariff episode may be treated as a new cost; ask the clinic in advance what period the price covers.
5. Translation and documents. Translation in both directions, notarisation and, where needed, an apostille; the Translation price calculator will help you estimate this item.

Once you have filled in this list with figures, it becomes clear which part to take to the referral commission and which to a charitable source. For the commission, a written cost estimate is the main argument, so it must be based on the clinic's invoice, not a verbal estimate.

Funding sources in one table

The referral commission is not meant to replace another source but to fill what is left. So apply to the commission together with the Agency's or City Hall's decision, so that it is clear which part has already been funded.

After the transplant: medicines, follow-up and our help

The tariff also includes management of the post-transplant period, but recovery often lasts longer than a single inpatient episode. Ruxolitinib purchased under Universal Healthcare is also given to onco-haematology patients, including children under 18, for steroid-refractory graft-versus-host disease (GVHD) that develops after a transplant. The rules differ for other medicines, so when they are prescribed, ask the treating doctor to note next to each medicine which programme can provide it.

If the transplant was done abroad, the local haematologist should have complete, translated discharge documentation waiting when you return home: the treatment protocol, medicines with doses, the follow-up schedule and contact details for the foreign team. Translate new results promptly and keep them in one digital archive so that both sides see the same information.

Advocat.Ge lawyers, as part of our funding search service, check the application to the Agency and City Hall, draft the letter to the referral commission for the amount remaining above the tariff and, where necessary, appeal a refusal. Translation with notarisation is done by our medical translation service. We do not provide funding and have no influence on the state's decision; our job is to make sure your package is complete and on time.

Frequently asked questions about funding a bone marrow transplant