OBJECTIVES: Transfusion-dependent β-thalassemia (TDT) is a rare genetic hemoglobinopathy with currently limited curative options. This study aims to describe the burden of TDT in France. METHODS: Retrospective analysis of the SNDS database, abstracting data from 01-01-2007 to 31-12-2016. Patient identification criteria included: ≥1 occurrence before age 50 of one of the ICD10 β thalassemia-related codes (D56.1, D56.2 D56.8 or D56.9) in hospitalization records and in Long Term Sickness registration database (D56 code); ≥8 blood transfusions (BT) within any 12-month period. Descriptive analyses included patients’ clinical characteristics, BT episodes, iron chelation therapy (ICT) use and healthcare resource utilization. RESULTS: A total of 448 patients with TDT were included in the analysis (49% male), of which 31% were diagnosed during the study period. Median age at first occurrence of diagnosis was 4 (0-47) years old. Of the 140 patients diagnosed after 2007, both first BT and first ICT use occurred at a median age of 5 (BT: 0-40; ICT: 1-42) years old. Across all patients, average number of BT per patient per year was 11±5, and 23% of patients had BT-related complications, in particular ‘Adverse event due to blood and its products in therapeutic use’ (68%). Almost all patients required ICT (96%), and combination therapy was used by 21% of them. Average number of hospitalizations was 13±6 per patient per year. BT accounted for 86% of the total hospitalization records. A total of 376 (84%) patients had ≥1 overnight hospitalization, with a median length of stay of 7 days. Almost all patients (99%) required ≥1 outpatient visit during the study period; 81% had ≥1 Emergency Room visit (with or without subsequent hospitalization). All-cause mortality rate was 7.1% (n=32) over study period, and death median age was 37 (5-55) years old. CONCLUSIONS: In France, TDT is associated with high clinical and economic burden.