Cost Effectiveness of Once-Daily Oral Chelation Therapy with Deferasirox versus Infusional Deferoxamine in Transfusion-Dependent Thalassaemia Patients: US Healthcare System Perspective
Thomas E. Delea (Policy Analysis Inc. (PAI), Brookline, Massachusetts, USA) Oleg Sofrygin (Policy Analysis Inc. (PAI), Brookline, Massachusetts, USA) Simu K. Thomas (Novartis Pharmaceuticals Corp., East Hanover, New Jersey, USA) Jean-Francois Baladi (Novartis Pharmaceuticals Corp., East Hanover, New Jersey, USA) Pradyumna D. Phatak (Hematology/Oncology Unit Rochester General Hospital, Rochester, New York, USA) Thomas D. Coates (Center for Cancer and Blood Diseases, Childrens Hospital of Los Angeles, Los Angeles, California, USA)
Abstract
Background: Deferasirox is a recently approved once-daily oral iron chelator that has been shown to reduce liver iron concentrations and serum ferritin levels to a similar extent as infusional deferoxamine. Objective: To determine the cost effectiveness of deferasirox versus deferoxamine in patients with beta-thalassaemia major from a US healthcare system perspective. Methods: A Markov model was used to estimate the total additional lifetime costs and QALYs gained with deferasirox versus deferoxamine in patients with beta-thalassaemia major and chronic iron overload from blood transfusions. Patients were assumed to be 3 years of age at initiation of chelation therapy and to receive prescribed dosages of deferasirox and deferoxamine that have been shown to be similarly effective in such patients. Compliance with chelation therapy and probabilities of iron overload-related cardiac disease and death by degree of compliance were estimated using data from published studies. Costs ($US, year 2006 values) of deferoxamine administration and iron overload-related cardiac disease were based on analyses of health insurance claims of transfusion-dependent thalassaemia patients. Utilities were based on a study of patient preferences for oral versus infusional chelation therapy, as well as published literature. Probabilistic and deterministic sensitivity analyses were employed to examine the robustness of the results to key assumptions. Results: Deferasirox resulted in a gain of 4.5 QALYs per patient at an additional expected lifetime cost of $US126 Conclusion: Results of this analysis of the cost effectiveness of oral deferasirox versus infusional deferoxamine suggest that deferasirox is a cost effective iron chelator from a US healthcare perspective.
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Article provided by Wolters Kluwer Health | Adis in its journal PharmacoEconomics.
Volume (Year): 25 (2007) Issue (Month): 4 () Pages: 329-342 Download reference. The following formats are available: HTML,
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