A Cost-of-Illness analysis of β-Thalassaemia major in children in Sri Lanka – Experience from a tertiary level teaching hospital

Reed-Embleton, Hamish, Arambepola, Savinda, Dixon, Simon, Maldonado, Behrouz Nezafat Maldonado, Premawardhena, Anuja, Arambepola, Mahinda, Khan, Jahangir ORCID: https://orcid.org/0000-0002-6151-764X and Allen, Stephen ORCID: https://orcid.org/0000-0001-6675-249X (2020) 'A Cost-of-Illness analysis of β-Thalassaemia major in children in Sri Lanka – Experience from a tertiary level teaching hospital'. BMC Pediatrics, Vol 29, Issue 257.

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Abstract

Background: Sri Lanka has a high prevalence of b-thalassaemia major. Clinical management is complex and long-term and includes regular blood transfusion and iron chelation therapy. The economic burden of β-thalassaemia for the Sri Lankan healthcare system and households is currently unknown.

Methods: A prevalence-based, cost-of-illness study was conducted on the Thalassaemia Unit, Department of Paediatrics, Kandy Teaching Hospital, Sri Lanka. Data were collected from clinical records, consultations with the head of the blood bank and a consultant paediatrician directly involved with the care of patients, alongside structured interviews with families to gather data on the personal costs incurred such as those for travel.

Results: Thirty-four children aged 2-17 years with transfusion dependent thalassaemia major and their parent/guardian were included in the study. The total average cost per patient year to the hospital was $US 2601 of which $US 2092 were direct costs and $US 509 were overhead costs. Mean household expenditure was $US 206 per year with food and transport per transfusion ($US 7.57 and $US 4.26 respectively) being the highest cost items. Nine (26.5%) families experienced catastrophic levels of healthcare expenditure (>10% of income) in the care of their affected child. The poorest households were the most likely to experience such levels of expenditure. Conclusions: β-thalassaemia major poses a significant economic burden on health services and the families of affected children in Sri Lanka. Greater support is needed for the high proportion of families that suffer catastrophic out-of-pocket costs.

Item Type:	Article
Subjects:	W General Medicine. Health Professions > W 74 Medical economics. Health care costs WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WH Hemic and Lymphatic Systems > Hematologic Diseases. Immunologic Factors. Blood Banks > WH 190 Hemoglobin and other hemeproteins. Porphyrins (Associated with hemoglobin) WS Pediatrics > Diseases of Children and Adolescents > By System > WS 300 Hemic and lymphatic system
Faculty: Department:	Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):	https://doi.org/10.1186/s12887-020-02160-3
Depositing User:	Marie Hatton
Date Deposited:	29 May 2020 08:26
Last Modified:	29 May 2020 08:26
URI:	https://archive.lstmed.ac.uk/id/eprint/14518

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