WESTPORT, CT (Reuters Health) - Given that the per-patient decade cost of chronic transfusion plus chelation therapy to prevent stroke in patients with sickle cell disease is nearly $400,000, alternative therapies should be considered, according to the results of a cost analysis published in the October 1st issue of Blood.

Dr. Alan S. Wayne, from the National Cancer Institute, Bethesda, Maryland, and colleagues evaluated the financial impact of chronic transfusion to prevent stroke in 21 patients with sickle cell disease. The researchers analyzed outpatient charges based on Medicare uniform bill (UB-92) codes, professional fees and iron chelation therapy.

The team's analysis showed that the "charges ranged from $9828 to $50,852 per patient per year." Fifty-three percent of these costs, they say, were UB-92 charges. The remaining charges were for chelation therapy (42%) and for physician fees (5%). Fifty-eight percent of the UB-92 fees were for laboratory costs and 16% were used to process and administer blood.

Additionally, they note that "charges for patients who required chelation therapy ranged from $31,143 to $50,852 per patient per year," with deferoxamine accounting for 71% of the chelation charges, "which ranged from $12,719 to $24,845 per patient per year." Therefore, for patients who also needed deferoxamine chelation, Dr. Wayne's group calculated that the decade cost per patient was almost $400,000.

Not only are the costs associated with transfusion therapy high, Dr. Wayne's groups adds, "the benefits of chronic transfusion are not permanent, and toxicity can limit long-term effectiveness." The investigators believe that "these factors should be considered in reference to cost and efficacy of alternative therapies for sickle cell disease, such as hydroxyurea and allogeneic bone marrow transplantation."

(From Reutershealth)