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Aydinok Y, Purushotham S, Yucel A, Glassberg M, Deshpande S, Potrata B, Trapali M, Shah F. Systematic literature review of the indirect costs and humanistic burden of β-thalassemia. Ther Adv Hematol 2024; 15:20406207241270872. [PMID: 39297078 PMCID: PMC11409307 DOI: 10.1177/20406207241270872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 06/17/2024] [Indexed: 09/21/2024] Open
Abstract
Background β-Thalassemia is an inherited blood disorder requiring lifetime management of anemia and its complications. Objective This study aimed to determine the indirect costs and humanistic burden of β-thalassemia. Design A systematic literature review was conducted. Data sources and methods Searches were conducted in Embase, MEDLINE, MEDLINE In-Process, and EconLit (November 1, 2010, to November 25, 2020). Studies reporting indirect costs and health-related quality of life (HRQoL) for patients with β-thalassemia were eligible. Results Seventy-five publications were included. Mean annual days lost due to transfusion-related absenteeism ranged from 15.6 to 35 days. Patients spent a mean of 592 min (standard deviation (SD): 349) daily on disease management on transfusion days and 91 min (SD: 221) daily on non-transfusion days. Patients with non-transfusion-dependent β-thalassemia (NTDT) showed worse HRQoL versus those with transfusion-dependent β-thalassemia (TDT) on the 36-item Short Form Health Survey (75.8 vs 66.5; p = 0.021). Caregivers of patients with TDT had more severe stress compared with patients (20.17 vs 18.95; p = 0.006), as measured by the standardized Cohen Perceived Stress Questionnaire. Conclusion TDT is associated with substantial indirect costs and caregiver burden, and NTDT is associated with worse HRQoL. There is an unmet need for novel treatments in both TDT and NTDT that minimize patient and caregiver burden.
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Affiliation(s)
- Yesim Aydinok
- Department of Pediatric Hematology, Faculty of Medicine, Ege University Hospital, Kazımdirik, Ankara Asfaltı, 35100 Bornova, ĺzmir, Turkey
| | | | | | | | | | | | | | - Farrukh Shah
- Department of Haematology, Whittington Health NHS Trust, London, UK
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Cappellini MD, Taher AT, Piga A, Shah F, Voskaridou E, Viprakasit V, Porter JB, Hermine O, Neufeld EJ, Thompson AA, Tang D, Yucel A, Lord-Bessen J, Yu P, Guo S, Shetty JK, Miteva D, Zinger T, Backstrom JT, Oliva EN. Health-related quality of life in patients with β-thalassemia: Data from the phase 3 BELIEVE trial of luspatercept. Eur J Haematol 2023. [PMID: 37095595 DOI: 10.1111/ejh.13975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 03/24/2023] [Accepted: 03/28/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND Patients with transfusion-dependent (TD) β-thalassemia require long-term red blood cell transfusions (RBCTs) that lead to iron overload, impacting health-related quality of life (HRQoL). METHODS The impact of luspatercept, a first-in-class erythroid maturation agent, versus placebo on HRQoL of patients with TD β-thalassemia was evaluated in the phase 3 BELIEVE trial. HRQoL was assessed at baseline and every 12 weeks using the 36-item Short Form Health Survey (SF-36) and Transfusion-dependent Quality of Life questionnaire (TranQol). Mean change in HRQoL was evaluated from baseline to week 48 for patients receiving luspatercept + best supportive care (BSC) and placebo + BSC and between luspatercept responders and non-responders. RESULTS Through week 48, for both groups, mean scores on SF-36 and TranQol domains were stable over time and did not have a clinically meaningful change. At week 48, more patients who achieved clinical response (≥50% reduction in RBCT burden over 24 weeks) in the luspatercept + BSC group had improvement in SF-36 Physical Function compared with placebo + BSC (27.1% vs. 11.5%; p = .019). CONCLUSIONS Luspatercept + BSC reduced transfusion burden while maintaining patients' HRQoL. HRQoL domain improvements from baseline through 48 weeks were also enhanced for luspatercept responders.
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Affiliation(s)
| | - Ali T Taher
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Antonio Piga
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Farrukh Shah
- Department of Haematology, Whittington Health NHS Trust, London, UK
| | - Ersi Voskaridou
- Centre of Excellence in Rare Haematological Diseases-Haemoglobinopathies, Laiko General Hospital, Athens, Greece
| | | | - John B Porter
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Olivier Hermine
- Necker Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- Imagine Institute, INSERM Unité 1163, University of Paris, Paris, France
| | - Ellis J Neufeld
- St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Alexis A Thompson
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Derek Tang
- Bristol Myers Squibb, Princeton, New Jersey, USA
| | - Aylin Yucel
- Bristol Myers Squibb, Princeton, New Jersey, USA
| | | | - Peiwen Yu
- Evidera, Waltham, Massachusetts, USA
| | - Shien Guo
- Evidera, Waltham, Massachusetts, USA
| | | | | | | | - Jay T Backstrom
- Acceleron Pharma Inc., a Subsidiary of Merck & Co., Inc., Rahway, New Jersey, USA
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Knoth RL, Gupta S, Perkowski K, Costantino H, Inyart B, Ashka L, Clapp K. Understanding the Association between Red Blood Cell Transfusion Utilization and Humanistic and Economic Burden in Patients with β-Thalassemia from the Patients' Perspective. J Clin Med 2023; 12:jcm12020414. [PMID: 36675342 PMCID: PMC9861260 DOI: 10.3390/jcm12020414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 12/23/2022] [Indexed: 01/06/2023] Open
Abstract
We assessed the humanistic and economic burden of chronic red blood cell (RBC) transfusions on patients with β-thalassemia. This cross-sectional, US-based study included adults (≥18 years) who self-reported a β-thalassemia physician diagnosis and had received ≥1 RBC transfusion in the past 6 months. The outcomes included the Functional Assessment of Cancer Therapy-Anemia (FACT-An), Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and ad hoc questions about treatment experience, side effects, direct/indirect costs, and psychological burden. Overall, 100 patients completed the survey, of whom 70% experienced "moderate" to "extremely high" burden due to RBC transfusions, 81% reported iron overload, 42% reported compromised social lives. The mean FACT-An score was 132 (higher score indicates better outcomes; 0-188). Mean scores were 33/52 for fatigue and 20/28 for anemia symptoms in the previous 7 days. Health-related quality of life (HRQoL) temporarily improved after RBC transfusion, although patients continued to experience mild-to-severe depression and anxiety, substantial direct costs, compromised employment, and suboptimal quality of life. Over 6 months, patients dedicated a mean of 173 h to transfusion requirements and incurred out-of-pocket costs of USD 2239 for transfusions and USD 896 for additional care costs. These findings highlight the need for new treatment options to improve patient HRQoL and economic outcomes.
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Affiliation(s)
- Russell L Knoth
- Bristol Myers Squibb, 100 Nassau Park Blvd #300, Princeton, NJ 08540, USA
| | - Shaloo Gupta
- Cerner Enviza, an Oracle Company, 51 Valley Stream Pkwy, Malvern, PA 19355, USA
| | - Kacper Perkowski
- Cerner Enviza, an Oracle Company, 51 Valley Stream Pkwy, Malvern, PA 19355, USA
| | - Halley Costantino
- Cerner Enviza, an Oracle Company, 51 Valley Stream Pkwy, Malvern, PA 19355, USA
| | - Brian Inyart
- Cerner Enviza, an Oracle Company, 51 Valley Stream Pkwy, Malvern, PA 19355, USA
| | - Lauren Ashka
- Cerner Enviza, an Oracle Company, 51 Valley Stream Pkwy, Malvern, PA 19355, USA
| | - Kelly Clapp
- Cerner Enviza, an Oracle Company, 51 Valley Stream Pkwy, Malvern, PA 19355, USA
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Effect of Educational Intervention Based on the Theory of Planned Behavior on Mammography Performance in Iranian Women: a Randomized Controlled Trial Study. JOURNAL OF EDUCATION AND COMMUNITY HEALTH 2021. [DOI: 10.52547/jech.8.1.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Joveini H, Dehdari T, Hashemian M, Maheri M, Shahrabadi R, Rohban A, Mehri A, Eftekhar Ardebili H. Effects of an Educational Intervention on Male Students’ Intention to Quit Water Pipe Smoking: an Application of the Theory of Planned Behavior (TPB) and Health Action Process Approach (HAPA). JOURNAL OF EDUCATION AND COMMUNITY HEALTH 2020. [DOI: 10.29252/jech.7.2.73] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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