Contributions
Abstract: EP1220
Type: E-Poster Presentation
Session title: Sickle cell disease
Background
Sickle cell disease (SCD) is a haematological disorder caused by a mutation in the β-globin gene (HbS) and is characterized by multisystem clinical manifestations, which result in varied acute and chronic SCD-related complications. The most common complication is vaso-occlusive crisis (VOC). In the Middle East (ME), SCD prevalence varies from (0.04%>0.5%) and is localized in certain pockets within countries and is contributed by consanguinity, environmental factors, large sibship size and migration. The increased prevalence together with the complexity in its management, may lead to high utilization of healthcare resources posing a considerable economic burden on the healthcare system, patients, and the society. The paucity of literature on SCD burden, lack of systematic disease registry/databases and structured costs data in the ME challenges the understanding of the scope of the public health concern that SCD poses.
Aims
To estimate the economic burden associated with SCD management in Bahrain, Egypt, Kingdom of Saudi Arabia (KSA), Lebanon, and Oman.
Methods
An excel-based micro-costing analysis was carried out, to estimate the direct and indirect costs associated with SCD management in the countries of interest over a one-year period both from a payer and societal perspective. Data inputs included epidemiology data with health state (defined in model as acute and chronic events consuming resources during the year) and unit costs for SCD management. Data sources included an exhaustive literature review followed by a clinician survey (using Delphi method) which included 41 experts. All findings were further validated by a steering committee of 12 multidisciplinary experts representing the studied countries. The model structure and inputs have been elaborated in the figure. The total annual direct and indirect costs associated with SCD and VOC were calculated. Subgroup analyses were also performed for age groups (paediatrics, adolescents, and adults) and VOC frequencies per year (0, 1-2, 3-4, ≥5 VOCs).
Results
The overall economic SCD burden from Payer’s perspectives, across all ages, ranged from USD $1.3 Mn in Egypt to as high as USD $395 Mn in KSA for the management of 1,000 and 94,455 SCD patients, respectively. The model showed that the SCD societal burden in ME ranged from USD $1.79 Mn in Egypt to as high as $1.4 Bn in KSA mostly driven by productivity losses due to SCD. On average and across ME countries, the acute complications represented approximatively 75% of the total SCD burden, of these 58% were attributed to the VOC management costs. In terms of healthcare resources utilization, hospital visits (inpatients, outpatients, and emergency room (ER)) were the main utilized health service contributing, on average, 54% to the total burden. Patients with ≥5 VOC per year incurred the highest annual cost per patient across all countries. The table summarizes the main results per country as well as the overall average.
Conclusion
The findings highlighted the extensive utilization of healthcare resources associated with the management of SCD and its substantial impact on patients’ work productivity, across the studied countries. Patients with acute complications, primarily VOC events incurred the majority of the economic burden due to the need for hospital visits. The higher the number of VOC events per year the higher the need for medical care hence healthcare resources utilization. This study emphasizes the need for innovative and cost-efficient therapies for the prevention of VOCs and/or reduction of VOCs frequency.
Keyword(s):
Abstract: EP1220
Type: E-Poster Presentation
Session title: Sickle cell disease
Background
Sickle cell disease (SCD) is a haematological disorder caused by a mutation in the β-globin gene (HbS) and is characterized by multisystem clinical manifestations, which result in varied acute and chronic SCD-related complications. The most common complication is vaso-occlusive crisis (VOC). In the Middle East (ME), SCD prevalence varies from (0.04%>0.5%) and is localized in certain pockets within countries and is contributed by consanguinity, environmental factors, large sibship size and migration. The increased prevalence together with the complexity in its management, may lead to high utilization of healthcare resources posing a considerable economic burden on the healthcare system, patients, and the society. The paucity of literature on SCD burden, lack of systematic disease registry/databases and structured costs data in the ME challenges the understanding of the scope of the public health concern that SCD poses.
Aims
To estimate the economic burden associated with SCD management in Bahrain, Egypt, Kingdom of Saudi Arabia (KSA), Lebanon, and Oman.
Methods
An excel-based micro-costing analysis was carried out, to estimate the direct and indirect costs associated with SCD management in the countries of interest over a one-year period both from a payer and societal perspective. Data inputs included epidemiology data with health state (defined in model as acute and chronic events consuming resources during the year) and unit costs for SCD management. Data sources included an exhaustive literature review followed by a clinician survey (using Delphi method) which included 41 experts. All findings were further validated by a steering committee of 12 multidisciplinary experts representing the studied countries. The model structure and inputs have been elaborated in the figure. The total annual direct and indirect costs associated with SCD and VOC were calculated. Subgroup analyses were also performed for age groups (paediatrics, adolescents, and adults) and VOC frequencies per year (0, 1-2, 3-4, ≥5 VOCs).
Results
The overall economic SCD burden from Payer’s perspectives, across all ages, ranged from USD $1.3 Mn in Egypt to as high as USD $395 Mn in KSA for the management of 1,000 and 94,455 SCD patients, respectively. The model showed that the SCD societal burden in ME ranged from USD $1.79 Mn in Egypt to as high as $1.4 Bn in KSA mostly driven by productivity losses due to SCD. On average and across ME countries, the acute complications represented approximatively 75% of the total SCD burden, of these 58% were attributed to the VOC management costs. In terms of healthcare resources utilization, hospital visits (inpatients, outpatients, and emergency room (ER)) were the main utilized health service contributing, on average, 54% to the total burden. Patients with ≥5 VOC per year incurred the highest annual cost per patient across all countries. The table summarizes the main results per country as well as the overall average.
Conclusion
The findings highlighted the extensive utilization of healthcare resources associated with the management of SCD and its substantial impact on patients’ work productivity, across the studied countries. Patients with acute complications, primarily VOC events incurred the majority of the economic burden due to the need for hospital visits. The higher the number of VOC events per year the higher the need for medical care hence healthcare resources utilization. This study emphasizes the need for innovative and cost-efficient therapies for the prevention of VOCs and/or reduction of VOCs frequency.
Keyword(s):