OBJECTIVES

: The purpose of this study is to perform a Cost Effectiveness Analysis (CEA) among simple transfusion (ST), manual Red Blood Cell exchange (mRBCx) and automated Red Blood Cell exchange (aRBCx), the three different transfusion modalities that the Brazilian National Healthcare System (BNHS) currently uses to treat patients with Sickle Cell Disease (SCD).

METHODS

: Costs, technical and clinical data have been collected from PubMed, the ISPOR Scientific Database and several online government sources such as the SUS, saude.gov, etc. The most important cost drivers assessed were blood transfusion costs, medical equipment, disposables, complications/adverse events, chelation therapy, hospitalization and lives lost. They have been used to populate a cost model created with the Microsoft Excel Software.

RESULTS

: Our results reflect the costs and benefits’ differences among the three transfusion modalities for the Brazilian NHS. When considering the cost of treatment, consequence, complications, lives lost and live years lost, aRBCx is dominant over the other options. Yearly intervention cost per patient in Brazilian Reals (BRL): [ST 5672; mRBCx 10,810; aRBCx 19,519]. Yearly cost of treatment choice related in BRL: [ST 18,846.54; mRBCx 14,141.36; aRBCx 7,536.69]. Yearly cost of disease complications in BRL: [ST 178,441; mRBCx 180,667; aRBCx 159,344]. Cost of lives lost per patient in BRL per year: [ST 7,172; mRBCx 7,072; aRBCx 6,005]. Total yearly cost per patient estimated in BRL: [ST 1,268,963; mRBCx 1,284,126; aRBCx 1,161,913].

CONCLUSIONS

: aRBCx is the most cost-effective option among the three transfusion modalities for SCD patients for the BNHS. aRBCX promotes reduction in overall resources, disease burden, bed retention and the need for chelation therapy. We recommend the BNHS to develop strategies to facilitate the inclusion of aRBCx in guidelines (PCDT) for treating SCD and to promote the use of aRBCx as the main transfusion modality for this disease.