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Cost-Effectiveness of Hydroxyurea for Treatment of Children With Sickle Cell Anemia in Ghana

Sinaï Francisco Dias1, Brian Asare2, Lumbwe Chola3

  • 1Erasmus University Rotterdam, Erasmus School of Health Policy and Management, Department of Health Technology Assessment, Rotterdam, The Netherlands.

Value in Health Regional Issues
|January 17, 2026
PubMed

Insights

Hydroxyurea offers significant health benefits for Ghanaian children with sickle cell disease (SCD). This study suggests it is cost-effective, supporting its inclusion in national health insurance for improved pediatric SCD care.

Area of Science:

  • Health Economics
  • Pediatric Hematology
  • Public Health Policy

Background:

  • Sickle cell disease (SCD) is a major cause of early mortality in African children.
  • Hydroxyurea treatment shows therapeutic benefits for SCD but faces accessibility challenges in low- and middle-income countries.
  • Ghana's healthcare system seeks cost-effective interventions for pediatric SCD management.

Purpose of the Study:

  • To evaluate the cost-effectiveness of hydroxyurea compared to standard care for pediatric SCD in Ghana.
  • To inform policy decisions regarding coverage and reimbursement for hydroxyurea in Ghana.
  • To assess the economic value of hydroxyurea for improving health outcomes in children with SCD.

Main Methods:

  • A 17-year Markov model was developed from a Ghanaian payer's perspective.
  • Outcomes measured included life-years gained and disability-adjusted life-years (DALYs) averted.
  • Cost-effectiveness was assessed against WHO and country-specific willingness-to-pay thresholds, with sensitivity analyses performed.

Main Results:

  • The incremental cost-effectiveness ratio (ICER) was $1440.34 per DALY averted and $1823.89 per life-year gained.
  • Hydroxyurea was potentially cost-effective using the WHO threshold but not the alternative country-specific threshold.
  • Sensitivity analyses indicated that drug pricing significantly impacts the ICER, highlighting the need for price negotiations.

Conclusions:

  • Hydroxyurea provides substantial health benefits for Ghanaian children with SCD.
  • The findings support integrating hydroxyurea into Ghana's national health insurance benefits package.
  • Further research is needed on country-specific thresholds, long-term effects, and broader economic impacts in Ghana.
Abstract

Keywords:
Ghanacost-effectiveness analysissickle cell disease

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