Budget Impact of the Thalassemia Management under the National Health Security Scheme in ThailandA. Riewpaiboon*, S. Bunyadharokul, U. Chaikledkaew and K. Torcharus
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This study was aimed to determine the budget impact due to the proposed thalassemia management program for transfusion-dependent thalassemia children under the National Health Security Office. The budget impact analysis was conducted from the National Health Security Office (NHSO) perspective. The budget covered drugs, blood, medical devices, and medical services. The target population was transfusion-dependent beta-thalassemia children aged up to 15 years. The treatment regimen was modified from the proposal of the Thalassemia Foundation of Thailand, while the pattern of service utilization and unit cost were derived from a cost of illness study. The budget was presented based on 2007 prices. Sensitivity analysis was performed testing the effects of prices of chelating agents. It was found that the direct medical budget for 37,452 patients was 2.5 billion THB (US$ 1 = 34.56 Thai THB). This represented the amount needed for patients receiving high transfusion with single deferrioxamine (DFO) and low transfusion with combined iron chelation package. In addition, the budget of 1.9 billion THB was required for patients receiving high transfusion and low transfusion with combination package. The increased prices of iron chelators affected 29% to 63% of the total budget. The total budget for conventional treatment (high transfusion + low transfusion) was 1.5 billion THB. In conclusion, from existing conventional practice to the thalassemia management program, the budget increased from 27% to 68%. Consequently, the total expenditure ballooned from 1.9 to 2.5 billion THB per year. Moreover, the prices of iron chelating agents had a significant effect on the budget.
Keyword:
Thalassemia, disease management, budget impact analysis, national health security, Thailand
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