Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-12T19:47:02.486Z Has data issue: false hasContentIssue false
  • English
  • Français

Cost-effectiveness of prophylaxis against on-demand treatment in boys with severe hemophilia A in Iran

Published online by Cambridge University Press:  22 October 2009

Aliasghar Ahmad Kia Daliri ,
Hassan Haghparast  and
Jahanara Mamikhani
Aliasghar Ahmad Kia Daliri
Affiliation:
Ministry of Welfare and Social Security
Hassan Haghparast
Affiliation:
Karolinska Institute
Jahanara Mamikhani
Affiliation:
Behinpuyan Hutan Research Institute
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective: The aim of this study was to assess the incremental cost-effectiveness of on-demand versus prophylactic hemophilia therapy in Iran from a third-party payers’ perspective.

Methods: A retrospective chart review of twenty-five type A hemophiliacs who were treated in three hemophilia treatment centers was conducted. The patients were boys 0–9 years old receiving one of two treatments: (i) prophylaxis with concentrate at clinic; (ii) concentrate at clinic as on-demand. Fourteen boys received on-demand infusions for bleeding events, and eleven boys received infusions prophylaxis. Data were extracted from documents in the hemophilia treatment centers during a period of approximately 6 months.

Results: The patients receiving prophylactic treatment had fewer bleeding events each month (mean, 0.26 versus 2.74) but used more concentrate (225.31 versus 87.20 units/kg per month). Average monthly cost per patient in the prophylaxis group was approximately 1.9 times higher than in the on-demand group. Compared with on-demand infusion, prophylaxis costs 3,201,656 Rials (€213.45) per bleeding event prevented.

Conclusion: Prophylactic care markedly reduces the number of bleeding episodes, but at considerable cost.

Keywords

Cost-effectivenessProphylaxisOn-demandHemophiliaIran
Type
General Essays
Information
International Journal of Technology Assessment in Health Care , Volume 25 , Issue 4 , October 2009 , pp. 584 - 587
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. Aledort, LM, Haschmeyer, RH, Pettersson, H. A longitudinal study of orthopaedic outcomes for severe factor-VIII-deficient haemophiliacs. The Orthopaedic Outcome Study Group. J Intern Med. 1994;236:391–399.CrossRefGoogle ScholarPubMed
2. Berntorp, E, Astermark, J, Bjorkman, S, et al. Consensus perspectives on prophylactic therapy for haemophilia:summary statement. Haemophilia. 2003;9 (Suppl 1):1–4.CrossRefGoogle ScholarPubMed
3. European Commission. Proceedings of Blood Safety in the European Community: An Initiative for Optimal Use; 20–22 May 1999; Wildbad Kreuth. Langen: Paul-Ehrlich Institute; 1999.Google Scholar
4. Globe, DR, Curtis, RG, Koerper, MA. Utilization of care in haemophilia: a resource- based method for cost analysis from the Haemophilia Utilization Group Study (HUGS). Haemophilia. 2004;10 (Suppl 1):63–70.CrossRefGoogle Scholar
5. Iranian Haemophilia Society's Report. Tehran, Iran; 2007.Google Scholar
6. Karimi, M, Rahmani, S, Ardeshiri, R, et al. Cost of care in Iranian hemophilic patients. Iran Red Crescent Med J. 2007;9:154–157.Google Scholar
7. Liesner, RJ, Khair, K, Hann, IM. The impact of prophylactic treatment on children with severe haemophilia. Br J Haematol. 1996;92:973–978.CrossRefGoogle ScholarPubMed
8. Lippert, B, Berger, K, Berntorp, E, et al. Cost effectiveness of haemophilia treatment: A cross-national assessment. Blood Coagul Fibrinolysis. 2005;16:477–485.CrossRefGoogle ScholarPubMed
9. Manco-Johnson, MJ, Abshire, TC, Shapiro, AD, et al. Prophylaxis versus episodic treatment to prevent joint disease in boys with severe hemophilia. N Engl J Med. 2007;357:535–544.CrossRefGoogle ScholarPubMed
10. Martines-Murillo, C, Quintana, S, Ambriz, R, et al. An economic model of haemophilia in Mexico. Haemophilia. 2004;10:9–17.CrossRefGoogle Scholar
11. Miners, AH, Sabin, CA, Tolley, KH, et al. A Assessing the effectiveness and cost-effectiveness of prophylaxis against bleeding in patients with severe haemophilia and severe von Willebrand's disease. J Intern Med. 1998;244:515–522.Google ScholarPubMed
12. Miners, AH, Sabin, CA, Tolley, KH, et al. Cost-utility analysis of primary prophylaxis versus treatment on-demand for individuals with severe haemophilia. Pharmacoeconomics. 2002;20:759–774.CrossRefGoogle ScholarPubMed
13. Nilsson, IM, Berntorp, E, Lofqvist, T, et al. Twenty-five years’ experience of prophylactic treatment in severe haemophilia A and B. J Intern Med. 1992;232:25–32.CrossRefGoogle ScholarPubMed
14. Smith, PS, Teutsch, SM, Shaffer, PA, et al. Episodic versus prophylactic infusions for hemophilia A: A cost-effectiveness analysis. J Pediatrics. 1996;129:424–431.CrossRefGoogle ScholarPubMed
15. Szucs, TD, Offner, A, Schramm, W. Socioeconomic impact of haemophilia care: Results of a pilot study. Haemophilia. 1996;2:211–217.CrossRefGoogle ScholarPubMed
16. United Kingdom Haemophilia Centre Directors Organization Executive Committee. Guidelines on therapeutic products to treat haemophilia and other hereditary coagulation disorders. Haemophilia. 1997;3:63–77.CrossRefGoogle Scholar
17. Van Den Berg, HM, Fischer, K, Van Der Bom, JG. Comparing outcomes of different treatment regimens for severe haemophilia. Haemophilia. 2003;9 (Suppl 1):27–31.CrossRefGoogle ScholarPubMed