Cost–utility analysis of oral deferasirox versus infusional deferoxamine in transfusion-dependent β-thalassemia patients


  • This study was supported partially by a Grant 323 from Shiraz University of Medical Sciences.

Address reprint requests to: Mehdi Javanbakht, Health Management and Economics Research Center, School of Health Management and Information Sciences, Tehran University of Medical Sciences, PO Box 141765376, Tehran, Iran; e-mail:



Deferasirox (DFX) is a novel iron chelator that has been shown to have similar efficacy and safety compared with deferoxamine (DFO) in patients with β-thalassemia. The aim of this study was to determine the cost utility of DFX versus DFO in β-thalassemia major patients from Iran's society perspective.

Study Design and Methods

A Markov model has been developed to determine lifetime cost and quality-adjusted life-years (QALYs) of patients. To estimate the annual cost of each method, a cross-sectional study was conducted among two groups of patients who received DFO and DFX (n = 100 and n = 45, respectively). Also a time trade-off method was used to estimate the utility of two strategies. Finally a one-way and probabilistic sensitivity analysis was conducted to examine the strength of the results.


Our base-case analysis showed that estimated total lifetime costs per patient for DFX and DFO were 47,029 international dollar ($Int) and $Int143,522, respectively, while the estimated total discounted QALYs per person were 12.28 and 7.76, respectively. Calculated incremental cost-effectiveness ratio showed that DSX is a dominant therapy and its estimated lifetime net monetary benefit was $Int273,528.


We conclude that the use of DFX instead of DFO represents a cost-effective use of resources for treatment of iron overload in patients with β-thalassemia from Iran's society perspective.