Healthcare resource utilization and direct costs of transfusion-dependent thalassemia patients in Dubai, United Arab Emirates: a retrospective cost-of-illness study.
Direct costs
Dubai
Health policy
Healthcare resource utilization
Transfusion-dependent thalassemia
United Arab Emirates
Journal
BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677
Informations de publication
Date de publication:
05 Mar 2022
05 Mar 2022
Historique:
received:
25
07
2021
accepted:
22
02
2022
entrez:
6
3
2022
pubmed:
7
3
2022
medline:
9
3
2022
Statut:
epublish
Résumé
Patients with transfusion-dependent thalassemia (TDT) require lifelong blood transfusions and iron chelation therapy. Thus, patients afflicted with TDT often have to undergo blood transfusion and iron chelation therapy, which causes a major economic burden on them. However, this topic has not been reported in Dubai, United Arab Emirates (UAE). Hence, this study aimed to evaluate healthcare resource utilization and associated direct costs related to patients with TDT in Dubai, UAE. For this study, a retrospective prevalence-based cost-of-illness analysis based on the UAE healthcare system and patient perspectives was conducted among patients with TDT treated at the Dubai Thalassemia Center in 2019. Information regarding healthcare resource utilization and direct medical costs was collected from the billing system connected to the electronic medical record system. Patients and their families were interviewed for direct non-medical cost estimations. A total of 255 patients with TDT were included in the study. The mean annual direct medical cost was estimated at AED 131,156 (USD 35,713) (95% CI: 124,735 - 137,578). The main driver of the medical cost for the participants as iron chelation therapy AED 78,372 (95% CI: 72,671 - 84,074) (59.8%), followed by blood transfusions, which accounted for AED 34,223 (95% CI: 32,854 - 35,593) 26.1% of the total direct medical costs. The mean annual direct non-medical costs was AED 2,223 (USD 605) (95% CI: 1,946 - 2,500). Age (p < 0.001), severe serum ferritin levels (p = 0.016), the presence of complications (p < 0.001), and the type of iron chelation therapy (p < 0.001) were significant predictors of higher direct medical costs incurred by the participants. Transfusion-dependent thalassemia poses a substantial economic burden on the healthcare system, patients, and their families. Our results show that the highest medical cost proportion was due to iron chelation therapy. In this regard, efforts must be made to improve the patients' acceptance and satisfaction with their iron chelation therapy to increase their compliance and improve the effectiveness of treatment, which could play an essential role in controlling the economic burden of this disease. Moreover, greater support is essential for families that suffer catastrophic out-of-pocket expenses.
Sections du résumé
BACKGROUND
BACKGROUND
Patients with transfusion-dependent thalassemia (TDT) require lifelong blood transfusions and iron chelation therapy. Thus, patients afflicted with TDT often have to undergo blood transfusion and iron chelation therapy, which causes a major economic burden on them. However, this topic has not been reported in Dubai, United Arab Emirates (UAE). Hence, this study aimed to evaluate healthcare resource utilization and associated direct costs related to patients with TDT in Dubai, UAE.
METHODS
METHODS
For this study, a retrospective prevalence-based cost-of-illness analysis based on the UAE healthcare system and patient perspectives was conducted among patients with TDT treated at the Dubai Thalassemia Center in 2019. Information regarding healthcare resource utilization and direct medical costs was collected from the billing system connected to the electronic medical record system. Patients and their families were interviewed for direct non-medical cost estimations.
RESULTS
RESULTS
A total of 255 patients with TDT were included in the study. The mean annual direct medical cost was estimated at AED 131,156 (USD 35,713) (95% CI: 124,735 - 137,578). The main driver of the medical cost for the participants as iron chelation therapy AED 78,372 (95% CI: 72,671 - 84,074) (59.8%), followed by blood transfusions, which accounted for AED 34,223 (95% CI: 32,854 - 35,593) 26.1% of the total direct medical costs. The mean annual direct non-medical costs was AED 2,223 (USD 605) (95% CI: 1,946 - 2,500). Age (p < 0.001), severe serum ferritin levels (p = 0.016), the presence of complications (p < 0.001), and the type of iron chelation therapy (p < 0.001) were significant predictors of higher direct medical costs incurred by the participants.
CONCLUSION
CONCLUSIONS
Transfusion-dependent thalassemia poses a substantial economic burden on the healthcare system, patients, and their families. Our results show that the highest medical cost proportion was due to iron chelation therapy. In this regard, efforts must be made to improve the patients' acceptance and satisfaction with their iron chelation therapy to increase their compliance and improve the effectiveness of treatment, which could play an essential role in controlling the economic burden of this disease. Moreover, greater support is essential for families that suffer catastrophic out-of-pocket expenses.
Identifiants
pubmed: 35248046
doi: 10.1186/s12913-022-07663-6
pii: 10.1186/s12913-022-07663-6
pmc: PMC8897869
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
304Informations de copyright
© 2022. The Author(s).
Références
Value Health. 2015 Mar;18(2):161-72
pubmed: 25773551
Transfusion. 2016 May;56(5):1038-45
pubmed: 27041389
J Med Assoc Thai. 2012 Jul;95 Suppl 7:S211-6
pubmed: 23130457
Am J Hematol. 2019 May;94(5):E129-E132
pubmed: 30734350
J Pediatr Hematol Oncol. 2015 Apr;37(3):e162-9
pubmed: 26201037
Am J Hematol. 2008 Apr;83(4):263-70
pubmed: 17924547
Acta Haematol. 1998;100(1):49-53
pubmed: 9691147
Hemoglobin. 2011;35(5-6):581-8
pubmed: 22074124
Blood Rev. 2019 Nov;38:100594
pubmed: 31416718
J Res Health Sci. 2016 Summer;16(3):111-115
pubmed: 27840337
Asian J Transfus Sci. 2010 Jul;4(2):94-8
pubmed: 20859507
BMC Pediatr. 2020 May 27;20(1):257
pubmed: 32460774
Value Health. 2014 Nov;17(7):A526
pubmed: 27201661
Clin Drug Investig. 2011;31(7):493-505
pubmed: 21627338
Haematologica. 2015 Aug;100(8):e292-4
pubmed: 25911552
PLoS One. 2017 Jan 30;12(1):e0170485
pubmed: 28135306
Hum Mutat. 2010 May;31(5):505-20
pubmed: 20437613
Cochrane Database Syst Rev. 2016 Jun 14;(6):CD010517
pubmed: 27296775
Indian J Pediatr. 2003 Jun;70(6):477-81
pubmed: 12921315
Adv Hematol. 2010;2010:938640
pubmed: 20508726
Mediterr J Hematol Infect Dis. 2014 Feb 17;6(1):e2014012
pubmed: 24678389
Eur J Radiol. 2007 Mar;61(3):499-506
pubmed: 17166681
Am J Hematol. 2011 Sep;86(9):808-10
pubmed: 21850661
BMC Res Notes. 2010 Jan 30;3:29
pubmed: 20181056
Haematologica. 2010 Mar;95(3):345-8
pubmed: 20207838
Orphanet J Rare Dis. 2013 Sep 17;8:143
pubmed: 24044606
Blood. 2008 Jan 15;111(2):583-7
pubmed: 17951527
Biol Blood Marrow Transplant. 2018 Oct;24(10):2119-2126
pubmed: 29673692
Iran J Public Health. 2010;39(1):78-84
pubmed: 23112993
Ther Clin Risk Manag. 2007 Oct;3(5):795-805
pubmed: 18473004
Cochrane Database Syst Rev. 2019 Jun 28;6:CD012900
pubmed: 31250923
Am J Hematol. 2008 Jun;83(6):482-4
pubmed: 18186524
Lancet. 2000 Mar 4;355(9206):786-91
pubmed: 10711926
Orphanet J Rare Dis. 2021 Apr 7;16(1):157
pubmed: 33827621
Hematology Am Soc Hematol Educ Program. 2011;2011:451-8
pubmed: 22160073
Blood. 2011 Jul 28;118(4):884-93
pubmed: 21628399
Curr Med Res Opin. 2008 Jul;24(7):1905-17
pubmed: 18507891
Blood. 2011 Sep 29;118(13):3479-88
pubmed: 21813448
J Formos Med Assoc. 2013 Apr;112(4):221-9
pubmed: 23537869
Cold Spring Harb Perspect Med. 2012 Aug 01;2(8):
pubmed: 22908199
Biomed J. 2016 Feb;39(1):24-38
pubmed: 27105596
Indian J Pediatr. 2018 Feb;85(2):102-107
pubmed: 29119463
J Ayub Med Coll Abbottabad. 2014 Jul-Sep;26(3):297-300
pubmed: 25671931
Acta Haematol. 2013;130(2):64-73
pubmed: 23485589
Hemoglobin. 2013;37(4):359-68
pubmed: 23647352
Bone Marrow Transplant. 2006 Mar;37(6):569-74
pubmed: 16462756
Hemoglobin. 2001 May;25(2):247-53
pubmed: 11480786