Cost-benefit analysis of a national thalassaemia prevention programme in Israel

Abstract

Objective-In Israel (population 5.7 million) there are around 200 known living subjects with thalassaemia major, of whom around 80% are from the northern district. This study aims at examining the costs and benefits of a national screening programme to prevent thalassaemia in Israel. Measurements and main results-The lifetime healthcare costs of caring for a person born with thalassaemia major are $284 154. The costs of the home infusion service (33.1%) actually exceed the costs of the chelating agent itself (22.1%). The remaining 44.8% of costs are due to stay in hospital, operations, outpatient visits, laboratory tests, therapists, etc. Lost earnings and premature mortality costs account for a further $51 843 and $141 944 respectively for each case. A national screening programme would cost $900 197 and prevent around 13.4 homozygotes being born, at a cost of $67 369 for each birth prevented. The benefit-cost ratio of the programme to the health services is 4.22:1, which increases to 6.01:1 when a societal perspective is taken. However, around 13.0 homozygote births are still expected to occur, the majority owing to lack of compliance of patients at various stages in the screening process. The addition of a national health education programme for the higher risk non-Jewish population either nationally or in selected regions will incur extra costs, which may be covered by increased benefits as a result of better compliance with the screening programme. Conclusion-Israel should start to provide a nationwide thalassaemia screening programme as the monetary benefits to society (and even to the health services alone) will exceed the screening programmes costs. (J Med Screen 1998;5:120-126)

The α-Thalassemias

“…40 The benefits of accurate diagnosis of iron deficiency and other hemoglobinopathies -hemoglobin S and β-thalassemia in particular -should also be considered. Costbenefit analyses of β-thalassemia prevention programs in Quebec, 41 Iran, 42 Israel, 43,44 and the United Kingdom 45 have generally confirmed the overall benefits of such programs (i.e., the costs of prevention were lower than the costs of treatment), but the studies did not include α-thalassemia. In low-and middle-income countries, the implementation of such programs could benefit from existing infrastructures (e.g., ongoing screening programs for phenylketonuria or glucose-6-phosphate dehydrogenase deficiency) or could result in an overall improvement in access to health care for local communities.…”

Iron chelation therapy: Clinical effectiveness, economic burden and quality of life in patients with iron overload

“…Only four studies were identified that contained data related to the costs of infused ICT. [21][22][23][24] On the basis of the literature, a single composite list of cost variables (such as drug, equipment, monitoring toxic effects, and psychotherapist) was created to serve as the basis for the health economics component of the case report form. Frequency of use and unit cost data for each of these variables were identified from the literature, this study, administrative databases, and medical supply catalogues.…”

Financial burden of national health insurance for treating patients with transfusion-dependent thalassemia in Taiwan

“…2,3 The lifetime cost of treating a patient with thalassemia major is estimated to be d80 000 (4US$ 110 000) in the United Kingdom 4,5 and US$ 284 154 in Israel. 6 Recent data from the Taiwan Thalassemia Association indicate that more than 400 patients have b-thalassemia major or other transfusion-dependent thalassemias in Taiwan, and their treatment costs account for a considerable percentage of the Taiwan's National Health Insurance expenditure. The pediatric HSCT program started in Taiwan in 1984, when an allogeneic bone marrow transplantation was performed in a patient with bthalassemia major.…”