Productivity Loss and Associated Costs Among Patients with Transfusion-Dependent Thalassemia in Dubai, United Arab Emirates

Abstract

Objective The aim of this study was to assess the indirect burden of patients with transfusion-dependent thalassemia (TDT) in Dubai, the United Arab Emirates (UAE). Methods Adult patients with TDT were enrolled during blood transfusion sessions. Productivity loss for patients in the preceding four weeks was reported using the validated iMTA Productivity Cost Questionnaire (iPCQ). Results A total of 161 adult patients with TDT were included in the study. The annual total productivity loss cost at paid work among 79 employed patients was AED 17,230 (USD 4691) (95% CI: 12,302–22,159), out of which absenteeism contributed AED 10,328 (USD 2812) and presenteeism contributed AED 6902 (USD 1879), whereas the annual total productivity loss cost at unpaid work was AED 4053 (USD 1104) (95% CI: 3471–4661). The annual mean total indirect cost for paid and unpaid work was AED 21,283 (USD 5795). Monthly income, nationality, and having two and more disease complications were the significant predictors of higher productivity loss costs. Having previously had a splenectomy was a negative and significant predictor of productivity loss costs. Conclusion TDT was associated with substantial productivity loss and indirect costs in the UAE. Health policies that aim to control transfusion-dependent thalassemia effectively are necessary and could result in cost savings for patients and employers.

Systematic review and evidence gap assessment of the clinical, quality of life, and economic burden of alpha‐thalassemia

“…The broader search across all thalassemia subtypes returned 9946 hits. However, only 13 studies on α-thalassemia (including hemoglobin H disease [HbH: deletional and/or non-deletional] and α-thalassemia with unspecified genotype) met the inclusion criteria (Figure 1) [13][14][15][16][17][18][19][20][21][22][23][24][25]. Eight studies reported on clinical burden [14,[16][17][18][19][20][21][22], two studies each reported on HRQoL [24,25] and HCRU/costs outcomes [13,15], and one study reported on both clinical burden and HCRU/costs (Table 1) [23].…”

“…However, only 13 studies on α-thalassemia (including hemoglobin H disease [HbH: deletional and/or non-deletional] and α-thalassemia with unspecified genotype) met the inclusion criteria (Figure 1) [13][14][15][16][17][18][19][20][21][22][23][24][25]. Eight studies reported on clinical burden [14,[16][17][18][19][20][21][22], two studies each reported on HRQoL [24,25] and HCRU/costs outcomes [13,15], and one study reported on both clinical burden and HCRU/costs (Table 1) [23]. No economic evaluations such as cost-effectiveness studies were identified.…”

“…[UAE] = 2 [13,15]), two in the United States [14,23], and one in Italy [20]. Eleven studies [15][16][17][18][19][20][21][22][23][24][25] reported on patients with HbH, while two [13,14] reported on patients with α-thalassemia without specifying its genotype.…”

“…Three studies were in an α‐thalassemia‐only population [ 16 , 22 , 23 ] and 10 were in a mixed population (α‐thalassemia and other types) reporting separate subgroup data [ 13 – 15 , 17 – 21 , 24 , 25 ].…”

Combatting thalassemia in the United Arab Emirates

“…Employees in the UAE with thalassemia report lost productivity and absenteeism. 9 Studies in other countries highlight emotional and social problems among those with thalassemia and also possible interventions, 10 but research in the UAE is lacking. Research is also needed on support from family and community and non-government organisations.…”