OBJECTIVES:

A previous cost model created during a health technology evaluation organized by NICE in the UK, related to Sickle Cell Disease (SCD), identified the cost of a blood transfusion procedure, the cost of chelation and the cost of hospitalization as the main drivers of SCD cost for the UK health system. Our study intended to go beyond these cost drivers and to create a cost model that also includes cost of disease complications and the costs of a life lost.

METHODS:

The methods applied to create the cost model were 3-fold: a systematic literature review to identify the main cost drivers within sickle cell disease, a critical review of the model by an academic institute (i.c. the University of Sheffield) and review of the model by multiple clinicians seeing SCD patients.

RESULTS:

A universal health economic cost model was created that estimates the full cost of sickle cell disease in function of: healthcare policy, prescriber treatment choice, cost of treatment, cost of treatment complications (hospitalization and chelation), incidence of disease complications, cost of disease complications, mortality of disease complications, life expectancy and life years lost due to SCD. Incidence of disease complications varied largely per source and was built into the model as a dynamic variable that can be adjusted by the end-user.

CONCLUSIONS:

In the economic evaluation of treatment alternatives for sickle cell disease, looking only at direct treatment cost and complications of the treatment itself may largely underestimate the full cost of sickle cell disease. Health systems could additionally consider the cost of disease complications (by incidence, hospital stay, and treatment cost to overcome these complications) and life years lost.