OBJECTIVES: To estimate the economic and healthcare burden associated with blood transfusions (BTs) in transfusion-dependent beta-thalassemia (TDT) in Thailand and Brazil.

METHODS: This study involved 2 phases: a pragmatic literature review (PLR) and a survey. The PLR was performed using the PICOS (Patient, Intervention, Comparison, Outcome, Study)-based search strategy to identify observational studies published in English in the past 10 years from Embase^®, MEDLINE^®, and EconLit. Key search phrases were “clinical pathways”, “blood-supply shortages”, and “economic burden of TDT”. The ongoing cross-sectional survey among Thai and Brazilian healthcare stakeholders will determine the costs associated with BTs in patients with TDT.

RESULTS: Among the 800 articles identified, 137 were assessed for full-text review, 4 studies from Thailand were included, with no studies found from Brazil. These articles were supplemented by 20 desk references from both countries. The standard of care for TDT management was BTs and iron-chelation therapies. Both countries reported inadequate BT provision. In Thailand, this was due to blood shortage, poor management, or patient noncompliance. The Red Cross could supply only 2300 BT units/day against the total nationwide demand of 8000 BT units/day in hospitals across Thailand, which could affect adequate BTs in patients with TDT. A study in Brazil showed 41% of patients experienced barriers to BTs due to blood-supply shortage (35%), lack of phenotype-matched blood (31%), and delays in blood preparation (21%) in 2022. Economic burden data for TDT were available only for Thailand, which showed the healthcare cost/TDT patient/month was approximately 10,500 Thai Baht in 2009 (354 euros [2022 inflation-adjusted]).

CONCLUSIONS: This PLR demonstrated considerable inadequate BT provision in both countries, some of which was related to blood-supply shortage. The ongoing survey will provide further insights on the economic burden of TDT with a specific focus on inadequate BT provision and transfusion delays due to blood shortages.