Related Experiment Video
Updated: Jun 24, 2025
Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload
Published on: March 14, 2017
Comparison of Yearly Cost Related to Complications Between Deferasirox and Deferiprone Monotherapy in Thalassemia
Teny Tjitra Sari1, Pustika Amalia Wahidiyat, Ludi Dhyani Rahmartani
1Department of Pediatrics Hematology-Oncology Cipto Faculty of Medicine, Universit/Faculty of Medicine, University of Indonesia, Jakarta, Indonesia.
Insights
Deferiprone is a more cost-effective iron chelation therapy for thalassemia major patients in Indonesia, despite potential complications. This finding offers valuable insights for healthcare providers and policymakers managing this chronic condition.
Area of Science:
- Hematology
- Pharmacoeconomics
- Public Health
Background:
- Thalassemia major imposes a significant economic burden, with iron chelation therapy (ICT) being a major cost driver.
- Effective management of iron overload is crucial to mitigate toxic effects in thalassemia patients.
- Understanding the comparative costs of different ICTs is essential for healthcare resource allocation.
Purpose of the Study:
- To compare the costs of iron chelators used as monotherapy in thalassemia major patients in Indonesia.
- To evaluate the economic impact of different iron chelation strategies within a specific healthcare setting.
Main Methods:
- Retrospective analytical observational study using data from a thalassemia registry (2016-2019).
- Inclusion criteria: Thalassemia major patients aged ≥2 years on monotherapy ICT without prior therapy changes.
- Data collected: demographics, thalassemia type, ICT type, complications, and total annual costs.
Main Results:
- 249 patients included; 96.8% had beta-thalassemia; deferiprone was the most common chelator (86.7%).
- Common complications included cardiomyopathy, diabetes mellitus, delayed puberty, and malnutrition.
- Deferiprone demonstrated a lower mean annual cost (USD 3581) compared to deferasirox (USD 6004).
Conclusions:
- Deferiprone is a less costly option for iron overload treatment in thalassemia, recommended for consideration by Indonesian national health insurance.
- Despite lower costs, potential complications associated with deferiprone warrant further investigation.
- Further research is needed to identify factors contributing to complications in thalassemia patients undergoing ICT.
Background:
Hemoglobin disorders such as thalassemia major have created an economic burden on the health care system. Iron chelation therapy (ICT) is the most expensive cost component in patients with thalassemia. ICT was administered to reduce the toxic effects of iron overload. This study aims to compare the costs of iron chelators as monotherapy in patients with thalassemia major in Indonesia, specifically in Cipto Faculty of Medicine, Universit.
Methods:
This is a retrospective analytical observational study. Data were collected from the thalassemia registry from 2016 to 2019. Patients' age, gender, type of thalassemia, and type of iron chelation were recorded. Complications and total annual costs were evaluated. All thalassemia patients aged ≥2 years who were only receiving monotherapy ICT and had no history of therapy switching were eligible. We excluded subjects who moved out to other facilities or lost to follow-up.
Results:
From a total of 256 subjects, 249 subjects were included. The median age is 28 years old. Both sexes were represented equally. As many as 96.8% of subjects have thalassemia beta. Deferiprone was the most common iron chelator used (86.7%). Complications were observed in the subjects based on 4-year data collection; most of them were cardiomyopathy, diabetes mellitus, delayed puberty, and malnutrition ( P =0.422; P =0.867; P =0.004; and P =0.125, respectively). Deferiprone had a lower mean annual cost of USD 3581 than deferasirox, which had a cost of USD 6004.
Conclusions:
Cardiomyopathy, diabetes mellitus, delayed puberty, and malnutrition were the most common complications found in the study. This study showed that deferiprone should be taken as consideration as a drug of choice to treat iron overload in thalassemia provided by Indonesian national health insurance which is less costly despite the probability of complications found after the treatment was given. Further investigations are required to evaluate contributing factors of complications in thalassemia.
Related Concept Videos
01:22Bone Marrow Sampling and Transplants
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
01:11Renal Failure: Dose Adjustments
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...