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KMID : 0366220080430020089
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Korean Journal of Hematology
2008 Volume.43 No. 2 p.89 ~ p.97
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Economic Evaluation of Iron Chelation Agents: Oral Deferasirox versus Infusional Deferoxamine
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Kim Jin-Hyun
Kim Youn-Hee
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Abstract
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Background: Patients with transfusional iron overload have relied on treatment with deferoxamine, a standard chelating agent. Deferoxamine is administered by intravenous or subcutaneous infusion over an 8∼12 hour period 5∼7 times per week; however, administration of deferoxamine may lead to poor compliance and reduced quality of life in patients. The use of deferasirox, a once daily oral chelation agent, was recently approved. We conducted an economic evaluation of these two iron-chelating medications in transfusion-dependent patients.
Methods: The efficacy of oral deferasirox and infusion deferoxamine was assumed equal based on clinical trials of non-inferiority with the administration of 20mg/kg/day deferasirox versus 40mg/kg/day deferoxamine. Depending on the methods utilized for measuring administration time, travel time and convenience between the use of infusion and oral therapy, either cost analysis or cost-utility analysis was undertaken, respectively. Cost analysis included determination of direct medical costs (drug costs and administration costs), non-medical costs (travel costs), and indirect costs(productivity loss associated medical utilization). For cost utility analysis, the cost per QALYs (quality-adjusted life years) was calculated based on costs subtracting indirect costs (productivity loss) and gains of QALYs between the two agents.
Results: Deferasirox therapy resulted in a cost savings per patient of 23,471,777 Korean won based on cost analysis. Based on cost utility analysis, the cost per QALYs gained was ?398,576 Korean won (4,527,819 Korean won savings with a gain of 11.5 QALYs per patient).
Conclusion: The results of cost analysis and cost utility analysis of the use of oral deferasirox versus infusion deferoxamine showed that deferasirox is a more economical and potentially socially beneficial iron-chelating agent in Korea.
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KEYWORD
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Deferasirox, Deferoxamine, Iron chelating agents, Cost analysis, Cost utility analysis
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