title: Cost-utility analysis of oral deferasirox versus infusional deferoxamine in transfusion-dependent β-thalassemia patients.
abstract: BACKGROUND
  Deferasirox (DFX) is a novel iron chelator that has been shown to have similar efficacy and safety compared with deferoxamine (DFO) in patients with β-thalassemia. The aim of this study was to determine the cost utility of DFX versus DFO in β-thalassemia major patients from Iran's society perspective.
  
  
  METHODS
  A Markov model has been developed to determine lifetime cost and quality-adjusted life-years (QALYs) of patients. To estimate the annual cost of each method, a cross-sectional study was conducted among two groups of patients who received DFO and DFX (n = 100 and n = 45, respectively). Also a time trade-off method was used to estimate the utility of two strategies. Finally a one-way and probabilistic sensitivity analysis was conducted to examine the strength of the results.
  
  
  RESULTS
  Our base-case analysis showed that estimated total lifetime costs per patient for DFX and DFO were 47,029 international dollar ($Int) and $Int143,522, respectively, while the estimated total discounted QALYs per person were 12.28 and 7.76, respectively. Calculated incremental cost-effectiveness ratio showed that DSX is a dominant therapy and its estimated lifetime net monetary benefit was $Int273,528.
  
  
  CONCLUSIONS
  We conclude that the use of DFX instead of DFO represents a cost-effective use of resources for treatment of iron overload in patients with β-thalassemia from Iran's society perspective.
authors.affiliation: Health Economics Department, Health Care Management School, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Keshtkaran
authors.forename: Mehdi
authors.initials: M
authors.lastname: Javanbakht
authors.forename: Sedigheh
authors.initials: S
authors.lastname: Salavati
authors.forename: Atefeh
authors.initials: A
authors.lastname: Mashayekhi
authors.forename: Mehran
authors.initials: M
authors.lastname: Karimi
authors.forename: Bijan
authors.initials: B
authors.lastname: Nuri
mesh_terms: D000284:Administration, Oral; D000328:Adult; D001565:Benzoates / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D000077588:Deferasirox; D003676:Deferoxamine / Q000191:economics / Q000627:therapeutic use*; D016527:Drug Costs / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007492:Iran; D007502:Iron Chelating Agents / Q000191:economics / Q000627:therapeutic use*; D019190:Iron Overload / Q000188:drug therapy* / Q000191:economics / Q000209:etiology; D008297:Male; D008390:Markov Chains; D018803:Models, Economic; D019057:Quality-Adjusted Life Years; D065227:Transfusion Reaction; D016896:Treatment Outcome; D014230:Triazoles / Q000191:economics / Q000627:therapeutic use*; D017086:beta-Thalassemia / Q000150:complications / Q000191:economics / Q000628:therapy*
chemical_list: D001565:Benzoates; D007502:Iron Chelating Agents; D014230:Triazoles; D003676:Deferoxamine; D000077588:Deferasirox