Analysis of the cost of treating hydroxyurea versus chelating agent with blood transfusion in pediatric patients with thalassemia: a retrospective analysis

Background: Thalassemia is a group of genetically inherited blood disorders due to defective haemoglobin chains. Patients require continuous blood transfusions throughout the life which results in iron overload and toxic injury to various organs. So, there is always a need for chelation therapy which further increase the cost of therapy and affect the quality of life of patients. Aim of the Study: This study was conducted to analyze and compare the cost of treatment for Hydroxyurea and Chelating agents with blood transfusions in thalassemia, their clinical outcomes and success of therapy. Methodology: It was a retrospective cohort study conducted on pediatric thalassemia patients in tertiary care hospitals of Multan and Khanewal, Pakistan for six months. Results: The average cost of treatment in terms of direct medical cost in HU and BT treatments were Rs:1105.25 ± 392.62 and Rs:14219.27 ± 4124.22 respectively. Hydroxyurea treatment has relatively less (4.16%) adverse reaction than chelating agents (36.44%). Although it is not a blood group related disease, in this study, 54% of the sample have O +ive blood group. Conclusion: Hydroxyurea is better, both in terms of safety and cost of treatment than chelating agents to address iron overload with blood transfusion therapy in thalassemia.