Deferasirox for the treatment of iron overload associated with regular blood transfusions (transfusional haemosiderosis) in patients suffering with chronic anaemia: a systematic review and economic evaluation

Abstract

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Pharmacoeconomic Considerations in Treating Iron Overload in Patients with β-Thalassaemia, Sickle Cell Disease and Myelodysplastic Syndromes in the US

“…[29] In all available studies, the cost associated with administering DFO had a significant impact on the ICER of deferasirox versus DFO. For example, the UK health technology assessment by McLeod et al [35] showed that, under the assumption that all patients used a traditional pump to administer DFO, deferasirox was cost effective for patients aged 2-10 years (ICER <d30 000 per QALY). If it was assumed that all patients were to use a balloon infuser instead of an infusion pump to administer DFO, use of deferasirox would be a dominant strategy compared with DFO (i.e.…”

“…deferosirox and deferiprone) may need to use input from clinical studies for the two drugs that have used a common comparator such as DFO. McLeod et al, [35] in their costeffectiveness assessment of deferiprone and deferosirox, calculated costs using the published cost estimates for monitoring, administration and treatment with ICT. Similarly, due to the lack of utility data for deferiprone, McLeod et al [35] used published utility estimates for DFO and deferosirox to calculate QALYs for deferiprone.…”

CONIFER - Non-Interventional Study to Evaluate Therapy Monitoring During Deferasirox Treatment of Iron Toxicity in Myelodysplastic Syndrome Patients with Transfusional Iron Overload

“…However, given the exploratory nature of the study, the heterogeneity of the study cohort and the high rate of concomitant disease, these results must be interpreted with caution. Furthermore, several controlled trials as well as meta-analysis confirmed the safety and effectiveness of deferasirox and the current study showed no new safety signals [9,13,25,26]. Nevertheless, a monthly monitoring of renal parameters is recommended for patients with normal renal function, whereas weekly monitoring is recommended in patients with pre-existing renal impairment [23].…”

Cost-utility of chelators in transfusion-dependent β-thalassemia major patients: a review of the pharmacoeconomic literature

“…Additionally, the efficacy models used in this work assumed a difference in cardiac iron clearance and cardiac outcomes between DFO and DFX, an assumption that is not supported by subsequent research [24]. This Health Technology Assessment report from the UK focuses mainly on cost-utility analyses of DFO versus DFX, but also includes brief mention of DFP [37]. The economic model is short-term only and does not include AEs.…”