School of Health and Environment Studies, Hamdan Bin Mohammed Smart University, Dubai, UAE.
Department of Health Management, Istinye University, Istanbul, Turkey.
BMC Health Serv Res. 2022 Mar 5;22(1):304. doi: 10.1186/s12913-022-07663-6.
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.
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.
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.
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.
依赖输血的地中海贫血症（TDT）患者需要终身输血和铁螯合治疗。因此，受 TDT 影响的患者经常需要接受输血和铁螯合治疗，这给他们带来了巨大的经济负担。然而，在阿拉伯联合酋长国（阿联酋）的迪拜，尚未有相关报道。因此，本研究旨在评估迪拜、阿联酋 TDT 患者的医疗资源利用情况及相关直接医疗费用。
本研究采用基于阿联酋医疗体系和患者观点的回顾性患病率成本效益分析，纳入 2019 年在迪拜地中海贫血中心接受治疗的 TDT 患者。从与电子病历系统相连的计费系统中收集有关医疗资源利用和直接医疗费用的信息。对患者及其家属进行直接非医疗费用估算的访谈。
共纳入 255 名 TDT 患者。估计每年直接医疗费用为 131156 阿联酋迪拉姆（35713 美元）（95%CI：124735-137578）。参与者的医疗费用主要由铁螯合治疗（AED78372，95%CI：72671-84074）（59.8%）驱动，其次是输血，占总直接医疗费用的 34223 阿联酋迪拉姆（AED34223，95%CI：32854-35593）（26.1%）。每年直接非医疗费用平均为 2223 阿联酋迪拉姆（605 美元）（95%CI：1946-2500）。年龄（p<0.001）、严重血清铁蛋白水平（p=0.016）、并发症的存在（p<0.001）和铁螯合治疗类型（p<0.001）是参与者直接医疗费用较高的显著预测因素。
依赖输血的地中海贫血症给医疗体系、患者及其家庭带来了巨大的经济负担。我们的结果表明，最高的医疗费用比例归因于铁螯合治疗。在这方面，必须努力提高患者对铁螯合治疗的接受度和满意度，以提高他们的依从性，提高治疗效果，这对于控制这种疾病的经济负担至关重要。此外，需要为那些承受灾难性自付费用的家庭提供更大的支持。
