Hydroxyurea use in prevention of stroke recurrence in children with sickle cell disease in a developing country: A cost effectiveness analysis.
We undertook a cost effectiveness analysis (CEA) of hydroxyurea (HU) in preventing stroke recurrence and/or death. We followed 43 children with sickle cell disease from 2000 to 2009 after having a first clinical stroke, of whom 10 opted for HU therapy. HU use led to decreased stroke recurrence and death without significantly increasing the annual cost of care per patient (J$83,250 vs. J$76,901, P = 0.491). The incremental cost effectiveness ratio (ICER) for prevention of stroke recurrence amounted to J$169,238 (US$1,900), while that for death prevention equalled J$635,843 (US$7,140). HU may be recommended when safe and affordable transfusion therapy is not feasible.
Department of Community Health and Psychiatry, University of the West Indies, Mona, Kingston, Jamaica.
Colette
C
Cunningham-Myrie
Department of Economics, University of the West Indies, Mona, Kingston, Jamaica.
Abdullahi
A
Abdulkadri
Sickle Cell Unit, TMRI, University of the West Indies, Mona, Kingston, Jamaica.
Andre
A
Waugh
Sickle Cell Unit, TMRI, University of the West Indies, Mona, Kingston, Jamaica.
Susanna
S
Bortolusso Ali
Sickle Cell Unit, TMRI, University of the West Indies, Mona, Kingston, Jamaica.
Lesley-Gaye
LG
King
Sickle Cell Unit, TMRI, University of the West Indies, Mona, Kingston, Jamaica.
Jennifer
J
Knight-Madden
Tropical Metabolism Research Unit, TMRI, University of the West Indies, Mona, Kingston, Jamaica.
Marvin
M
Reid
D000755:Anemia, Sickle Cell / Q000150:complications* / Q000188:drug therapy / Q000191:economics; D000986:Antisickling Agents / Q000191:economics / Q000627:therapeutic use*; D002648:Child; D003362:Cost-Benefit Analysis; D003906:Developing Countries; D005260:Female; D006801:Humans; D006918:Hydroxyurea / Q000191:economics / Q000627:therapeutic use*; D007563:Jamaica; D008297:Male; D012008:Recurrence; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*
D000986:Antisickling Agents; D006918:Hydroxyurea
Neurology & sickle cell; Outcomes research; sickle cell disease