Economic burden of adult patients with ß-thalassaemia major in mainland China.

BACKGROUND: ß-thalassaemia major poses a substantial economic burden, especially in adults. We aimed to estimate the economic burden of adult patients with ß-thalassaemia major from a societal perspective using the real-world data. According to the clinical guideline, we also estimated the annual medical costs for patients with the same body weight and calculated the lifetime medical costs over 50 years in mainland China. METHODS: This was a retrospective cross-sectional study. An online survey with snowball sampling covering seven provinces was conducted. We extracted patient demographics, caregiver demographics, disease and therapy information, caring burden, and costs for adult patients diagnosed with ß-thalassaemia major and their primary caregivers. In the real world, we estimated the annual direct medical cost, direct nonmedical cost, and indirect cost. In addition, we calculated the annual direct medical cost and lifetime direct medical cost by weight with discounted and undiscounted rates according to the clinical guideline. RESULTS: Direct medical costs was the main driver of total cost, with blood transfusion and iron chelation therapy as the most expensive components of direct medical cost. In addition, adult patients with ß-thalassaemia major weighing 56 kg were associated with an increase of $2,764 in the annual direct medical cost using the real-world data. The undiscounted and discounted (5% discount rate) total lifetime treatment costs were $518,871 and $163,441, respectively. CONCLUSIONS: Patients with ß-thalassaemia major often encounter a substantial economic burden in mainland China. Efforts must be made to help policymakers develop effective strategies to reduce the burden and pevalence of thalassaemia.

Assessment of organ and effective doses received by adult patients undergoing computed tomography in three hospitals in Brazzaville, Congo Republic.

The present study aimed to evaluate adult patient data collected from three hospitals in Brazzaville, Congo Republic, for the purpose of estimating organ and effective doses for each included examination type. A total of 1277 adult patients (aged 16-97 years) who underwent head, chest, abdominopelvic (AP), chest-abdomen-pelvis (CAP), and lumbar spine computed tomography scans were considered. The organ and effective doses were estimated using a Monte Carlo-based method. The effective doses were also determined using k-factors. In general, the organ and effective doses estimated in this study were higher than those reported in the literature. The k-factor method underestimated the effective dose by up to 65.9%. This study demonstrates that urgent steps should be taken to reduce doses administered to patients to optimal levels. Such optimal levels may be achieved by adopting local diagnostic reference levels, together with the implementation of dose reduction strategies.