title: Cost-Utility Analysis of Three Iron Chelators Used in Monotherapy for the Treatment of Chronic Iron Overload in β-Thalassaemia Major Patients: An Italian Perspective.
abstract: OBJECTIVE
  Deferiprone (DFP), deferasirox (DFX) and deferoxamine (DFO) are used in thalassaemia major (TM) patients to treat chronic iron overload. We evaluated the cost-effectiveness of DFP, compared with DFX and DFO monotherapy, from an Italian healthcare system perspective.
  
  
  METHODS
  A Markov model was used over a time horizon of 5 years. Italian-specific cost data were combined with Italian efficacy data. Costs and quality-adjusted life years (QALYs) were calculated for each treatment, with cost-effectiveness expressed as cost per QALY.
  
  
  RESULTS
  In all scenarios modelled, DFP was the dominant treatment strategy. Sensitivity analyses showed that DFP dominated the other treatments with a >99% likelihood of being cost-effective against DFX and DFO at a willingness to pay threshold of €20,000 per QALY.
  
  
  CONCLUSIONS
  DFP was the dominant and most cost-effective treatment for managing chronic iron overload in TM patients. Its use can result in substantial cost savings for the Italian healthcare system.
authors.affiliation: Magnetic Resonance Imaging Unit, Fondazione G. Monasterio CNR-Regione Toscana, Area della Ricerca S. Cataldo, Via Moruzzi, 56124, Pisa, Italy. alessia.pepe@ftgm.it.
authors.forename: Alessia
authors.initials: A
authors.lastname: Pepe
authors.affiliation: Epidemiology and Biostatistics Unit, Institute of Clinical Physiology, CNR, Pisa, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Rossi
authors.affiliation: Decision Resources Group Abacus, Bicester, Oxfordshire, UK.
authors.forename: Anthony
authors.initials: A
authors.lastname: Bentley
authors.affiliation: Dipartimento di Pediatria, Clinica di Emato-Oncologia Pediatrica, Università di Padova/Azienda Ospedaliera, Padua, Italy.
authors.forename: Maria Caterina
authors.initials: MC
authors.lastname: Putti
authors.affiliation: Dipartimento di Pediatria, Clinica di Emato-Oncologia Pediatrica, Università di Padova/Azienda Ospedaliera, Padua, Italy.
authors.forename: Ludovica
authors.initials: L
authors.lastname: Frizziero
authors.affiliation: U.O. Microcitemie, A.O. "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy.
authors.forename: Domenico Giuseppe
authors.initials: DG
authors.lastname: D'Ascola
authors.affiliation: U.O.C. Ematologia con Talassemia, ARNAS Ospedale Civico, Palermo, Italy.
authors.forename: Liana
authors.initials: L
authors.lastname: Cuccia
authors.affiliation: U.O.S.D. Centro per le Microcitemie, AORN Cardarelli, Naples, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Spasiano
authors.affiliation: U.O.S.D. Centro per le Microcitemie, AORN Cardarelli, Naples, Italy.
authors.forename: Aldo
authors.initials: A
authors.lastname: Filosa
authors.affiliation: U.O.D. Talassemia, ARNAS "Garibaldi", Catania, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Caruso
authors.affiliation: Decision Resources Group Abacus, Bicester, Oxfordshire, UK.
authors.forename: Aishah
authors.initials: A
authors.lastname: Hanif
authors.affiliation: Magnetic Resonance Imaging Unit, Fondazione G. Monasterio CNR-Regione Toscana, Area della Ricerca S. Cataldo, Via Moruzzi, 56124, Pisa, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Meloni
mesh_terms: D001565:Benzoates / Q000008:administration & dosage / Q000191:economics; D015331:Cohort Studies; D003362:Cost-Benefit Analysis / Q000379:methods*; D000077588:Deferasirox; D000077543:Deferiprone; D003676:Deferoxamine / Q000008:administration & dosage / Q000191:economics; D004333:Drug Administration Routes; D017048:Health Care Costs; D006801:Humans; D007502:Iron Chelating Agents / Q000008:administration & dosage / Q000191:economics*; D007558:Italy / Q000453:epidemiology; D011728:Pyridones / Q000008:administration & dosage / Q000191:economics; D016896:Treatment Outcome; D014230:Triazoles / Q000008:administration & dosage / Q000191:economics; D017086:beta-Thalassemia / Q000188:drug therapy* / Q000191:economics* / Q000453:epidemiology
chemical_list: D001565:Benzoates; D007502:Iron Chelating Agents; D011728:Pyridones; D014230:Triazoles; D000077543:Deferiprone; D003676:Deferoxamine; D000077588:Deferasirox