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  4. A pharmaco-economic evaluation of deferasirox for treating patients with iron overload caused by transfusion-dependent thalassemia in Taiwan
 
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A pharmaco-economic evaluation of deferasirox for treating patients with iron overload caused by transfusion-dependent thalassemia in Taiwan

Journal
Journal of the Formosan Medical Association
Journal Volume
112
Journal Issue
4
Pages
221-229
Date Issued
2013
Author(s)
Ho W.-L.
Chung K.-P.
Yang S.-S.
MENG-YAO LU  
SHIANN-TANG JOU  
HSIU-HAO CHANG  
YUNG-LI YANG  
Lin D.-T.
Lin K.-H.
DOI
10.1016/j.jfma.2011.08.020
URI
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84875603535&doi=10.1016%2fj.jfma.2011.08.020&partnerID=40&md5=d470ebdb14220e8909f67e9433b994c9
https://scholars.lib.ntu.edu.tw/handle/123456789/526426
Abstract
Background/Purpose: The newly available iron chelator deferasirox (Exjade, Novartis) is expected to provide better long-term clinical outcomes and improved quality of life for patients with thalassemia than its predecessor, deferoxamine (Desferal, Novartis), because of its oral tablet form. Methods: We used the Markov model to estimate total additional lifetime costs and quality-adjusted life years (QALYs) gained with deferasirox versus deferoxamine in patients with transfusion-dependent thalassemia. Patients were assumed to be 2 years of age at initiation of chelation therapy. Clinical outcomes in terms of morbidity and mortality from associated complications and life expectancy for the study population were estimated using the databases of the Bureau of National Health Insurance and the Health and Vital Statistics of Taiwan. Treatment costs were based on analyses of health insurance claims for patients with transfusion-dependent thalassemia. Utilities in terms of quality of life were also included in the model. The incremental cost-utility ratio of deferasirox versus deferoxamine was defined by the ratio of the difference in expected lifetime costs to the difference in QALYs. One-way sensitivity analyses were performed to examine the robustness of the results to key assumptions. Results: Patients treated with deferasirox are expected to experience a lower incidence of associated complications and obtain 2.3 QALYs (discounted) at an additional lifetime cost of US$36,291 per patient (US$15,596 per QALY). Sensitivity analyses showed that the unit drug cost of deferasirox had the greatest impact on the incremental cost-utility ratio. In addition, the incremental cost-utility ratio will increase by delaying the starting age (2 years of age in our study) of chelation therapy. Conclusion: Compared with infusional deferoxamine, oral deferasirox improved clinical outcomes and quality of life in terms of iron chelation in transfusion-dependent patients with thalassemia at a reasonable cost from a healthcare perspective. ? 2012.
SDGs

[SDGs]SDG3

Other Subjects
deferasirox; deferoxamine; article; cause of death; chelation therapy; child; clinical evaluation; controlled study; cost utility analysis; diabetes mellitus; drug cost; health insurance; heart disease; hidden Markov model; human; hypogonadism; hypoparathyroidism; hypothyroidism; iron overload; life expectancy; morbidity; mortality; patient compliance; preschool child; quality of life; sensitivity analysis; Taiwan; thalassemia; transfusion dependent thalassemia; treatment outcome; Benzoates; Blood Transfusion; Child, Preschool; Deferoxamine; Health Care Costs; Humans; Iron Chelating Agents; Iron Overload; Markov Chains; Quality-Adjusted Life Years; Thalassemia; Triazoles
Type
journal article

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