The Economic Burden of Treating Thalassemia In Greece

Abstract

was calculated. Considering a switch to aztreonam lysine, the reduction of exacerbation was estimated in order to maintain the overall treatment cost. For the base case, ex-factory prices were considered; for sensitivity analysis, discounts ranged from 15 to 50%. Results: Switching to aztreonam lysine would not increase overall treatment costs in 8/12 options; even maintaining current exacerbation episodes could lead to SNS savings. In the remaining options, the required reduction of exacerbations varies depending on the patient's current situation, ranging from 110% (one episode/ year) to 18% (six episodes/year). In the sensitivity analysis, there are 3 options in which switching to aztreonam lysine would not imply higher treatment costs. For the remaining alternatives, the required reduction of exacerbations does not change significantly from the base case: from 116% (one episode/year) to 19% (six episodes/ year). ConClusions: In CF patients with chronic pulmonary infection by PA, hospitalizations costs due to exacerbations have a greater economic impact than drug treatment costs. Using aztreonam lysine, instead of other treatments, would not imply a budget impact in a wide range of patient profiles if exacerbation episodes can be reduced. As the number of current exacerbations increases, a lesser reduction of these events is required by a switch to aztreonam lysine to avoid incremental treatment costs.objeCtives: Meprobamate is a constituent of various combination analgesics in South Africa. Due to its abuse potential, the scheduling status of meprobamate is currently under review with the possibility of introducing stricter controls on its availability. The primary aim was to determine the impact of generic substitution on meprobamate-containing combination analgesic prescribing. Methods: A retrospective, cross-sectional drug utilisation study was conducted on prescription data of a medical insurance scheme administrator in South Africa for 2011. Results: A total of 97 491 analgesics were dispensed to 31 854 patients during the year. Within ATC category N02B, 62.10% of prescriptions were for analgesic combinations, of which 20 326 prescriptions were for meprobamate-containing analgesics at a cost of R282 930. A total of 10 404 patients received meprobamate-containing analgesics. Overall, 20.85% of all analgesics contained meprobamate. Patients who received meprobamate-containing analgesics were slightly older (39.52 years) compared to patients who received analgesics in general (33.61 years). Mandatory generic substitution exists in South Africa, unless otherwise indicated by the prescriber or if the patient refuses. Twenty-two trade names of meprobamate-containing analgesics were dispensed, of which 17 (the originator plus 16 branded generics) contained exactly the same dosages of active ingredients (320 mg paracetamol, 8 mg codeine phosphate, 32 mg caffeine and 150 mg meprobamate). In previous studies, the originator product was the most often prescribed, yet in this study the originator product only consti...

Healthcare resource utilization and direct costs of transfusion-dependent thalassemia patients in Dubai, United Arab Emirates: a retrospective cost-of-illness study

“…The study findings revealed that the total direct medical costs per TDT patient per year were AED 131,156 (USD 35,710) (USD 1 = AED 3.67), of which ICT was the most expensive cost component (59.8%), followed by blood transfusions (26.1%). The findings of this study have shown that the annual mean direct medical cost is in agreement with that found in other studies conducted in Western countries, such as Greece (EUR 32,054) [23] and Italy (EUR 31,883) [13], but lower than that found in studies conducted in the United States (USD 43,969 and USD 128,969) [16,29]. Contrarily, our estimates are higher than those reported in middle-and lowincome countries such as Turkey (USD 14,360) [12], Thailand (USD 563) [15], India (USD 1135) [31], and Iran (EUR 1,731) [24] (USD 7,287) [14].…”

“…Patients treated with DFO had a significantly lower number of blood transfusion units than those treated with other ICTs. Contrastingly, another study showed that DFX reduced blood transfusion volume in relation to DFO [ 23 ]. This difference could be explained by the difference of sex in patients treated with DFO.…”

“…Estimates of the direct medical costs associated with TDTs were almost consistent in different studies. Direct medical costs for patients with TDT are generally high [ 39 ], and most studies conclude that blood transfusions and ICT are the two main drivers of direct medical costs associated with TDT [ 13 , 14 , 23 ]. The study findings revealed that the total direct medical costs per TDT patient per year were AED 131,156 (USD 35,710) (USD 1 = AED 3.67), of which ICT was the most expensive cost component (59.8%), followed by blood transfusions (26.1%).…”

“…Most of the cost-of-illness studies on TDT have revealed that the costs of lifelong conventional therapy for thalassemia are high and place an enormous economic burden on the healthcare system as well as the patients [16][17][18]. This massive economic burden is majorly attributed to blood transfusions and iron chelation therapy (ICT) [16,[19][20][21][22][23]. Other studies have also revealed that blood transfusion and nursing services and comprise the lion share of the total medical expenditure [24], and that ICT and in-hospital stay are the most expensive components of direct medical cost [12].…”

Changing patterns in the epidemiology of β‐thalassemia

“…In the United Kingdom, total healthcare expenditure attributable to managing β‐thalassemia major over 50 years was estimated to be USD 720 201 at 2013‐2014 prices 78 . A study of 331 patients with β‐thalassemia in Greece found that the mean annual cost per patient, including all treatment strategies, was EUR 32 064 for the period 2009 to 2011, a value that increased from EUR 30 997 in 2009 to EUR 32 564 in 2011 79 . In Iran, a study of the economic burden of β‐thalassemia major found that the average annual cost per patient was USD 8321.80, regardless of the cost of lost welfare 80 .…”