原创力文档a cost-utility and budget impact analysis of allogeneic hematopoietic stem cell transplantation for severe thalassemic patients in thailand成本效用和预算影响分析严重thalassemic同种异体造血干细胞移植的患者在泰国.pdfVIP
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a cost-utility and budget impact analysis of allogeneic hematopoietic stem cell transplantation for severe thalassemic patients in thailand成本效用和预算影响分析严重thalassemic同种异体造血干细胞移植的患者在泰国
Leelahavarong et al. BMC Health Services Research 2010, 10:209
/1472-6963/10/209
RESEARCH ARTICLE Open Access
A cost-utility and budget impact analysis of
allogeneic hematopoietic stem cell
transplantation for severe thalassemic patients in
Thailand
1,2 1,2* 3 4 1,5
Pattara Leelahavarong , Usa Chaikledkaew , Suradej Hongeng , Vijj Kasemsup , Yoel Lubell ,
Yot Teerawattananon1
Abstract
Background: Hematopoietic stem cell transplantation (HSCT) is the only curative treatment available to severe
thalassemic patients. The treatment, however, is very costly, particularly in the context of low and middle income
countries, and no studies have been carried out to explore its economic justifiability. This study aimed to estimate
the cost-utility of HSCT compared with blood transfusions combined with iron chelating therapy (BT-ICT) for severe
thalassemia in Thailand, and to investigate the affordability of HSCT using a budget impact analysis.
Methods: A Markov model was used to estimate the relevant costs and health outcomes over the patients’
lifetimes taking a societal perspective as recommended by Thailand’s health technology assessment guidelines. All
future costs and outcomes were discounted at a rate of 3% per annum. Primary outcomes of interest were lifetime
costs, quality adjusted life years (QALYs) gained, and the incremental cost-effectiveness ratio (ICER) in Thai baht
(THB) per QALY gained.
Results: Compared to BT-ICT, the incremental cost-effectiveness ratio increased with patient age from 80,700 to
183,000 THB per QALY gained for related HSCT and 209,000 to 953,000 THB per QALY gained for unrelated HSCT
among patients aged 1 to 15 years (US$1= 34 THB). The governmental budget impact ana
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