Iron Chelation With Deferoxamine

Deferoxamine mesylate (DFO) reduces morbidity and mortality associated with transfusional iron overload. Data on the utilization and costs of care among U.S. patients receiving DFO in typical clinical practice are limited however. This was a retrospective study using a large U.S. health insurance claims database spanning 1/97-12/04 and representing 40 million members in >70 health plans. Study subjects (n 5 145 total, 106 sickle cell disease [SCD], 39 thalassemia) included members with a diagnosis of thalassemia or SCD, one or more transfusions (whole blood or red blood cells), and one or more claims for DFO. Mean transfusion episodes were 12 per year. Estimated mean DFO use was 307 g/year. Central venous access devices were required by 20% of patients. Cardiac disease was observed in 16% of patients. Mean total medical costs were $59,233 per year including $10,899 for DFO and $8,722 for administration of chelation therapy. In multivariate analyses, potential complications of iron overload were associated with significantly higher medical care costs. In typical clinical practice, use of DFO in patients with thalassemia and SCD receiving transfusions is low. Administration costs represent a large proportion of the cost of chelation therapy. Potential complications of iron overload are associated with increased costs. Am. J. Hematol. 83:263-270, 2008. V

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Outcomes, utilization, and costs among thalassemia and sickle cell disease patients receiving deferoxamine therapy in the United States

Delea

Hagiwara

Thomas

et al. 2007

American J Hematol

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Weekend Very High-dose Intravenous Deferoxamine in Children With Transfusional Iron Overload

Nelson¹,

Hennessy²,

McDonough³

et al. 2006

Journal of Pediatric Hematology/Oncology

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Iron overload can be a major complication in children requiring chronic red cell transfusions. Compliance with subcutaneous deferoxamine is often poor. We report the use of very high-dose deferoxamine in 14 children. Patients received intravenous deferoxamine at 15 mg/kg/h over 48 hours every 2 or 4 weeks. The mean duration of treatment was 18 months. Therapy was well tolerated and our regimen was successful in removing excess iron. Intermittent very high-dose intravenous deferoxamine is practical, safe, and effective in managing iron overload in children. Treatment can be given as an outpatient without a central venous catheter.

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Consequences and costs of noncompliance with iron chelation therapy in patients with transfusion‐dependent thalassemia: a literature review

et al. 2007

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Iron Chelation With Deferoxamine

Abstract: Iron overload can be effectively managed with alteration of DFO doses and routes using a consistent approach. Modification of administration methods, including administration of DFO during red blood cell transfusions, are indicated to attain ferritin levels of <2,000 ng/mL.

Cited by 5 publications

References 17 publications

Outcomes, utilization, and costs among thalassemia and sickle cell disease patients receiving deferoxamine therapy in the United States

Outcomes, utilization, and costs among thalassemia and sickle cell disease patients receiving deferoxamine therapy in the United States

Weekend Very High-dose Intravenous Deferoxamine in Children With Transfusional Iron Overload

Consequences and costs of noncompliance with iron chelation therapy in patients with transfusion‐dependent thalassemia: a literature review

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