A Glance at the Cost of Chelation Therapy with Desferal and Exjade in Iran

Background: Thalassemia is a series of hemoglobinopathies in which the production of perfect hemoglobin is completely or partially suppressed. Using injectable iron chelators have been dominating treatment for the iron overload caused by recurrent blood transfusions in thalassemic patients, however, a new oral iron chelating drug (Exjade) have been recently introduced and might be cost effective compared to previous treatment methods. This study was undertaken to evaluate the cost of Exjade in comparison with injectable iron chelators. Patients and Methods: In this retrospective study, we calculated the cost of iron chelation with Deferoxamine mesylate or Desferal in three groups of patients including those with optimum moderate and poor compliance. Afterwards, we compared the cost with the cost of iron chelation using Exjade. The cost of drugs and treatment for complications caused by iron overload were both taken into account. Results: The average cost of treatment per year with Deferoxamine mesylate was 85601032 Rials for patients with poor compliance, 62739714 Rials for patients with moderate compliance, and 50118376 Rials for patients with optimum compliance. In addition, according to the latest price of Exjade in Iranian market, we found out a regular oral iron chelation therapy using Exjade, with a dose of 20 mg/kg, to cost 76650000 Rials per year. Conclusion: Our findings indicate that using Exjade is cost-effective for those patients who have poor compliance to parenteral treatment. More investigations should be implemented to find the social and economic impact of Exjade therapy on quality of life among patients needing iron chelation therapy. Keywords: Thalassemia, hemoglobinopathies, iron chelating agents, deferasirox, deferoxamine