Economic burden in the management of transfusion-dependent thalassaemia patients in Malaysia from a societal perspective

Shafie, Asrul Akmal; Wong, Jacqueline Hui Yi; Ibrahim, Hishamshah Mohd; Mohammed, Noor Syahireen; Chhabra, Irwinder Kaur

doi:10.1186/s13023-021-01791-8

Cited by 12 publications

(10 citation statements)

References 31 publications

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“…The unit costs for out-patient visits and hospitalisation costs were calculated by applying current charges for full fee-paying patients to MOH hospitals (Hospital Putrajaya, 2022;Hospital Selayang, 2022). Transfusion costs were estimated for packed cells, platelet, cross matching and transfusion equipment (Shafie et al, 2021). All HRU unit costs were standardised to index year of 2021.…”

Section: Unit Costmentioning

confidence: 99%

Cost of Treatment for Myelofibrosis Patients in Ministry of Health Hospitals in Sarawak, Malaysia

Tang

Leong

Ong³

et al. 2023

Asian Pac J Cancer Prev

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Objective: Primary myelofibrosis is a rare type of myeloproliferative neoplasm with an annual incidence rate of 0.47 per 100,000. A retrospective, observational study was conducted to determine the disease evolution and costs of treatment for myelofibrosis (MF) patients managed in 4 Ministry of Health (MOH) hospitals in Sarawak, Malaysia. Methods: The estimation of treatment cost was a planned analysis of the Real World Evidence (RWE) study which included retrospective chart review of adult MF patients treated in Sarawak General, Sibu, Bintulu and Miri Hospitals. The study was approved by Sarawak General Hospital HRRC and MREC. The current study was conducted to estimate the cost of out-patient visits, hospitalisation, transfusion and medication from the perspective of MOH. Out-patient visits and hospitalisation costs were calculated using current unit costs for full fee-paying charges of MOH hospitals. Transfusion costs were estimated for packed cell and platelet transfusions. Medication costs were calculated using drug prices from IQVIA database for MOH hospital sub-sector in 2021. Unit costs were standardised to index year of 2021. Result: Data from 63 patients was available for analysis. Mean annual health resource utilisation (HRU) was 6.13 clinic visits, 9.47 days of hospitalisation and 1.61 transfusions per patient per year. Mean HRU cost was RM23,320 (USD5,217) per patient per year, comprised of RM19,122 (USD4,278) in drug costs, RM3,030 (USD678) for hospitalisation, RM799 (USD178) for transfusions and RM368 (USD82) for outpatient cost. Conclusion: The present analysis suggests that medication and hospitalisation were the main drivers of costs for MF treatment in Sarawak MOH hospitals. This study provides the first RWE estimate of the cost of MF in Malaysia and may provide insight into unmet clinical needs and a guide for further health economic research into the treatment of MF.

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Section: Unit Costmentioning

confidence: 99%

Cost of Treatment for Myelofibrosis Patients in Ministry of Health Hospitals in Sarawak, Malaysia

Tang

Leong

Ong³

et al. 2023

Asian Pac J Cancer Prev

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“…Transfusion‐dependent patients are at risk for secondary iron overload, which can accumulate in target organs like the heart, liver, and endocrine glands, leading to high rates of morbidity, mortality, and healthcare resource utilization 2,3,5 . Despite the availability of effective iron chelation therapy, the psychosocial and economic burden of chronic treatment can lead to poor treatment adherence and diminished quality of life 6–11 . Thus, the search for novel therapeutic approaches that can ameliorate the need for transfusion therapy continues 12 .…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of clinically significant forms of alpha‐ and beta‐thalassemia: A global map of evidence and gaps

Musallam¹,

Lombard

Kistler³

et al. 2023

American J Hematol

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This systematic literature review assessed the global prevalence and birth prevalence of clinically significant forms of alpha‐ and beta‐thalassemia. Embase, MEDLINE, and the Cochrane Library were searched for observational studies published January 1, 2000, to September 21, 2021. Of 2093 unique records identified, 69 studies reported across 70 publications met eligibility criteria, including 6 records identified from bibliography searches. Thalassemia prevalence estimates varied across countries and even within countries. Across 23 population‐based studies reporting clinically significant alpha‐thalassemia (e.g., hemoglobin H disease and hemoglobin Bart's hydrops fetalis) and/or beta‐thalassemia (beta‐thalassemia intermedia, major, and/or hemoglobin E/beta‐thalassemia), prevalence estimates per 100 000 people ranged from 0.2 in Spain (over 2014–2017) to 27.2 in Greece (2010–2015) for combined beta‐ plus alpha‐thalassemia; from 0.03 in Spain (2014–2017) to 4.5 in Malaysia (2007–2018) for alpha‐thalassemia; and from 0.2 in Spain (2014–2017) to 35.7 to 49.6 in Iraq (2003–2018) for beta‐thalassemia. Overall, the estimated prevalence of thalassemia followed the predicted pattern of being higher in the Middle East, Asia, and Mediterranean than in Europe or North America. However, population‐based prevalence estimates were not found for many countries, and there was heterogeneity in case definitions, diagnostic methodology, type of thalassemia reported, and details on transfusion requirements. Limited population‐based birth prevalence data were found. Twenty‐seven studies reported thalassemia prevalence from non–population‐based samples. Results from such studies likely do not have countrywide generalizability as they tended to be from highly specific groups. To fully understand the global prevalence of thalassemia, up‐to‐date, population‐based epidemiological data are needed for many countries.

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“…Most of the cost-of-illness studies on TDT have revealed that the costs of lifelong conventional therapy for thalassemia are high and place an enormous economic burden on the healthcare system as well as the patients [16][17][18]. This massive economic burden is majorly attributed to blood transfusions and iron chelation therapy (ICT) [16,[19][20][21][22][23]. Other studies have also revealed that blood transfusion and nursing services and comprise the lion share of the total medical expenditure [24], and that ICT and in-hospital stay are the most expensive components of direct medical cost [12].…”

Section: Introductionmentioning

confidence: 99%

Healthcare resource utilization and direct costs of transfusion-dependent thalassemia patients in Dubai, United Arab Emirates: a retrospective cost-of-illness study

Alshamsi

Hamidi

Narcı

2022

BMC Health Serv Res

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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 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 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 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.

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Economic burden in the management of transfusion-dependent thalassaemia patients in Malaysia from a societal perspective

Cited by 12 publications

References 31 publications

Cost of Treatment for Myelofibrosis Patients in Ministry of Health Hospitals in Sarawak, Malaysia

Cost of Treatment for Myelofibrosis Patients in Ministry of Health Hospitals in Sarawak, Malaysia

Epidemiology of clinically significant forms of alpha‐ and beta‐thalassemia: A global map of evidence and gaps

Healthcare resource utilization and direct costs of transfusion-dependent thalassemia patients in Dubai, United Arab Emirates: a retrospective cost-of-illness study

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