Cost-Utility Analysis of Three Iron Chelators Used in Monotherapy for the Treatment of Chronic Iron Overload in β-Thalassaemia Major Patients: An Italian Perspective

Clin Drug Investig. 2017 May;37(5):453-464. doi: 10.1007/s40261-017-0496-1.

Abstract

Purpose: Deferiprone (DFP), deferasirox (DFX) and deferoxamine (DFO) are used in thalassaemia major (TM) patients to treat chronic iron overload. We evaluated the cost-effectiveness of DFP, compared with DFX and DFO monotherapy, from an Italian healthcare system perspective.

Methods: A Markov model was used over a time horizon of 5 years. Italian-specific cost data were combined with Italian efficacy data. Costs and quality-adjusted life years (QALYs) were calculated for each treatment, with cost-effectiveness expressed as cost per QALY.

Results: In all scenarios modelled, DFP was the dominant treatment strategy. Sensitivity analyses showed that DFP dominated the other treatments with a >99% likelihood of being cost-effective against DFX and DFO at a willingness to pay threshold of €20,000 per QALY.

Conclusions: DFP was the dominant and most cost-effective treatment for managing chronic iron overload in TM patients. Its use can result in substantial cost savings for the Italian healthcare system.

MeSH terms

  • Benzoates / administration & dosage
  • Benzoates / economics
  • Cohort Studies
  • Cost-Benefit Analysis / methods*
  • Deferasirox
  • Deferiprone
  • Deferoxamine / administration & dosage
  • Deferoxamine / economics
  • Drug Administration Routes
  • Health Care Costs*
  • Humans
  • Iron Chelating Agents / administration & dosage
  • Iron Chelating Agents / economics*
  • Italy / epidemiology
  • Pyridones / administration & dosage
  • Pyridones / economics
  • Treatment Outcome
  • Triazoles / administration & dosage
  • Triazoles / economics
  • beta-Thalassemia / drug therapy*
  • beta-Thalassemia / economics*
  • beta-Thalassemia / epidemiology

Substances

  • Benzoates
  • Iron Chelating Agents
  • Pyridones
  • Triazoles
  • Deferiprone
  • Deferoxamine
  • Deferasirox