Cargando…

Major Thalassemia, Screening or Treatment: An Economic Evaluation Study in Iran

Background: Beta-thalassemia minor and thalassemia major are an autosomal recessive disease with hypochromic, microcytic anemia, and morbidities, Today, therapeutic advances have significantly improved the life expectancy of thalassemia major patients, but at the cost of financial toxicity. The pres...

Descripción completa

Detalles Bibliográficos
Autores principales: Esmaeilzadeh, Firooz, Ahmadi, Batoul, Vahedi, Sajad, Barzegari, Saeed, Rajabi, Abdolhalim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Kerman University of Medical Sciences 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9808182/
https://www.ncbi.nlm.nih.gov/pubmed/33619933
http://dx.doi.org/10.34172/ijhpm.2021.04
_version_ 1784862881865531392
author Esmaeilzadeh, Firooz
Ahmadi, Batoul
Vahedi, Sajad
Barzegari, Saeed
Rajabi, Abdolhalim
author_facet Esmaeilzadeh, Firooz
Ahmadi, Batoul
Vahedi, Sajad
Barzegari, Saeed
Rajabi, Abdolhalim
author_sort Esmaeilzadeh, Firooz
collection PubMed
description Background: Beta-thalassemia minor and thalassemia major are an autosomal recessive disease with hypochromic, microcytic anemia, and morbidities, Today, therapeutic advances have significantly improved the life expectancy of thalassemia major patients, but at the cost of financial toxicity. The present study aimed to investigate the possibility of increasing the funding for thalassemia screening programs and comparing the cost-effectiveness of screening for thalassemia in the treatment of the patients. Methods: In this study, screening for thalassemia minor was compared with the treatment of thalassemia major patients. A decision tree model was used for analysis. A hospital database, supplemented with a review of published literature, was used to derive input parameters for the model. A lifetime study horizon was used and future costs and consequences were discounted at 3%. The approach of purchases of services was used to evaluate the screening test costs for patients with thalassemia major. Also, a bottom-up method was applied to estimate other screening and treatment costs. All the costs were calculated over one year. The number of gained quality-adjusted life years (QALYs) was calculated using the EQ-5D questionnaire in the evaluated patients. Results: In this study, 26.97 births of patients with thalassemia major were prevented by screening techniques. On the other hand, total screening costs for patients with thalassemia major were estimated equal to US$ 879879, while the costs of preventing the birth of each thalassaemia major patient was US$ 32 624 by screening techniques. In comparison, the cost of managing a patient with thalassemia major is about US$ 136 532 per year. The life time QALYs for this is 11.8 QALYs. Results are presented using a societal perspective. Incremental cost per QALY gained with screening as compared with managing thalassaemia major was US$ 11 571. Conclusion: Screening is a long-term value for money intervention that is highly cost effective and its long-term clinical and economic benefits outweigh those of managing thalassaemia major patients.
format Online
Article
Text
id pubmed-9808182
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Kerman University of Medical Sciences
record_format MEDLINE/PubMed
spelling pubmed-98081822023-01-10 Major Thalassemia, Screening or Treatment: An Economic Evaluation Study in Iran Esmaeilzadeh, Firooz Ahmadi, Batoul Vahedi, Sajad Barzegari, Saeed Rajabi, Abdolhalim Int J Health Policy Manag Original Article Background: Beta-thalassemia minor and thalassemia major are an autosomal recessive disease with hypochromic, microcytic anemia, and morbidities, Today, therapeutic advances have significantly improved the life expectancy of thalassemia major patients, but at the cost of financial toxicity. The present study aimed to investigate the possibility of increasing the funding for thalassemia screening programs and comparing the cost-effectiveness of screening for thalassemia in the treatment of the patients. Methods: In this study, screening for thalassemia minor was compared with the treatment of thalassemia major patients. A decision tree model was used for analysis. A hospital database, supplemented with a review of published literature, was used to derive input parameters for the model. A lifetime study horizon was used and future costs and consequences were discounted at 3%. The approach of purchases of services was used to evaluate the screening test costs for patients with thalassemia major. Also, a bottom-up method was applied to estimate other screening and treatment costs. All the costs were calculated over one year. The number of gained quality-adjusted life years (QALYs) was calculated using the EQ-5D questionnaire in the evaluated patients. Results: In this study, 26.97 births of patients with thalassemia major were prevented by screening techniques. On the other hand, total screening costs for patients with thalassemia major were estimated equal to US$ 879879, while the costs of preventing the birth of each thalassaemia major patient was US$ 32 624 by screening techniques. In comparison, the cost of managing a patient with thalassemia major is about US$ 136 532 per year. The life time QALYs for this is 11.8 QALYs. Results are presented using a societal perspective. Incremental cost per QALY gained with screening as compared with managing thalassaemia major was US$ 11 571. Conclusion: Screening is a long-term value for money intervention that is highly cost effective and its long-term clinical and economic benefits outweigh those of managing thalassaemia major patients. Kerman University of Medical Sciences 2021-02-03 /pmc/articles/PMC9808182/ /pubmed/33619933 http://dx.doi.org/10.34172/ijhpm.2021.04 Text en © 2022 The Author(s); Published by Kerman University of Medical Sciences https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Esmaeilzadeh, Firooz
Ahmadi, Batoul
Vahedi, Sajad
Barzegari, Saeed
Rajabi, Abdolhalim
Major Thalassemia, Screening or Treatment: An Economic Evaluation Study in Iran
title Major Thalassemia, Screening or Treatment: An Economic Evaluation Study in Iran
title_full Major Thalassemia, Screening or Treatment: An Economic Evaluation Study in Iran
title_fullStr Major Thalassemia, Screening or Treatment: An Economic Evaluation Study in Iran
title_full_unstemmed Major Thalassemia, Screening or Treatment: An Economic Evaluation Study in Iran
title_short Major Thalassemia, Screening or Treatment: An Economic Evaluation Study in Iran
title_sort major thalassemia, screening or treatment: an economic evaluation study in iran
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9808182/
https://www.ncbi.nlm.nih.gov/pubmed/33619933
http://dx.doi.org/10.34172/ijhpm.2021.04
work_keys_str_mv AT esmaeilzadehfirooz majorthalassemiascreeningortreatmentaneconomicevaluationstudyiniran
AT ahmadibatoul majorthalassemiascreeningortreatmentaneconomicevaluationstudyiniran
AT vahedisajad majorthalassemiascreeningortreatmentaneconomicevaluationstudyiniran
AT barzegarisaeed majorthalassemiascreeningortreatmentaneconomicevaluationstudyiniran
AT rajabiabdolhalim majorthalassemiascreeningortreatmentaneconomicevaluationstudyiniran