OBJECTIVES: This study was determined the budget impact due to advance the thalassemia management for transfusion-dependent thalassemia children under the Universal Health Coverage scheme (UC) in the fiscal year 2007. METHODS: The budget impact analysis was conducted from the National Health Security Office (NHSO) perspective. The budget impact was performed using the scenario analysis that specific to the treatment model, in which based on the proposed of the Thalassemia Foundation of Thailand (TFT) and conventional treatment. The input parameters such as the proportion of beta-thal, treatment regimen, and iron chelation price were programmed. The epidemiological data were derived from the prevalence of thalassemia in Thailand. The unit costs of medical services were relied on the Civil Servant Medical Benefit scheme (CSMBS) reimbursement of medical facilities in 2006, whereas the unit costs of iron chelators were derived from the drug-medical supply information center website, Ministry of Public Health. The costs were adjusted to 2007 by the consumer price index. RESULTS: In the base case scenario(TFT proposition), total direct medical costs of thalassemia management for 37,452 beta-thalassemia children under the UC, it was arranged the global budget of 2.5 billion Thai bahts in patients receiving high transfusion with single desferrioxamine (DFO) and low transfusion with combined iron chelation package by the NHSO’s need. In addition, the budget of 1.9 billion Thai baths was required for patients receiving high transfusion and low transfusion with combination package. The sensitivity analysis indicated that the global budget was about 1.5 to 4.3 billion Thai baths. Besides, variation of iron chelators was the major of total cost. CONCLUSIONS: The budget of base case was higher than the conventional treatment around 0.4 – 1.1 billion Thai bahts. Moreover, it was approximately 2.14 – 2.85%  of the total health budget of the NHSO in the fiscal year 2007.