title: Health care resource utilization and cost of care for haemophilia A and B patients in Iran.
abstract: BACKGROUND
  Despite the fact that the total therapeutic expenditure of haemophilia is paid by the national health system in Iran, a limited number of research has been performed to evaluate the economic burden of haemophilia. It is even more important when considering the fact that "prophylaxis" has never been used as the main treatment protocol in haemophiliacs in the country, causing high arthropathy rates. The aim of this study is to evaluate the cost drivers in the treatment of haemophilia A and B patients in Iran.
  
  
  METHODS
  The national registry database of Ministry of Health (MoH) was queried to identify total number of individuals characteristics diagnosed with Factor VIII and IX deficiency. The service package defined by the department for special diseases was used as the reference for the type and frequency of health care utilization in haemophiliacs in Iran. The direct medical costs including prescription, medical intervention, inpatient, outpatient and diagnostics services and arthroplasty were considered. The prices were extracted from Iranian medical tariff book 2014-15. Medication cost was obtained from the Iranian Food and Drug Organization.
  
  
  RESULTS
  Among 8,337 patients registered with bleeding disorders, 3,948 and 848 were identified with haemophilia A and B respectively, of whom 856 (18%) patients had inhibitor at any time in the past. In the two groups, 2,328 (59%) and 452 (53%) patients suffered from severe, 686 (17%) and 186 (22%) from moderate and 902 (23%) and 185 (22%) from mild type of haemophilia. The average annual health care cost for every patient was USD 15,130, mostly allocated to medication USD 10,180 (67%), followed by therapeutic services USD 4,775 (32%) while diagnostic services stood third USD 177 (1%).
  
  
  CONCLUSIONS
  There is an urgent need for developing clinical practice guidelines for treatment protocols, procedures and supportive care in haemophilia management in Iran.
authors: Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran; Pharmaceutical Management and Economics Research Center (PMERC), Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
authors: Zahra
authors: Z
authors: Gharibnaseri
authors: Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran; Pharmaceutical Management and Economics Research Center (PMERC), Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: m-davari@tums.ac.ir.
authors: Majid
authors: M
authors: Davari
authors: Department of Pharmacology, University of Baqiyatallah Medical Sciences, Tehran, Iran.
authors: Abdolmajid
authors: A
authors: Cheraghali
authors: Pediatric Congenital Hematologic Disorders Research Center, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors: Peyman
authors: P
authors: Eshghi
authors: Department of Physical Therapy, Biomechanical Research Laboratory, Tarbiat Modares University, Tehran, Iran.
authors: Roya
authors: R
authors: Ravanbod
authors: Department of Orthopedics, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors: Ramin
authors: R
authors: Espandar
authors: Ministry of Health and Medical Education, Tehran, Iran.
authors: Razieh
authors: R
authors: Hantooshzadeh
mesh_terms: D017048:Health Care Costs; D006295:Health Resources / Q000706:statistics & numerical data*; D006467:Hemophilia A / Q000175:diagnosis / Q000191:economics* / Q000628:therapy; D002836:Hemophilia B / Q000175:diagnosis / Q000191:economics* / Q000628:therapy; D006801:Humans; D007492:Iran
keywords: Cost; Haemophilia; Health care; Iran; Resource utilization