Nilawan Upakdee

Iron-chelating therapies in a transfusion-dependent thalassaemia population in Thailand: a cost-effectiveness study.

AbstractBackground and Objective: β-Thalassaemia is a major public health problem in Thailand. Use of appropriate iron-chelating agents could prevent thalassaemia-related complications, which are costly to the healthcare system. This study aimed to evaluate the cost effectiveness of deferoxamine (DFO), deferiprone (DFP) and deferasirox (DFX) in Thai transfusion-dependent β-thalassaemia patients from the societal perspective. Methods: A Markov model was used to project the life-time costs and outcomes represented as quality-adjusted life-years (QALYs). Data on the clinical efficacy and safety of all therapeutic options were obtained from a systematic review and clinical trials. Transition probabilities were derived from published studies. Costs were obtained from the Thai Drug and Medical Supply Information Center, Thai national reimbursement rate information and other Thai literature sources. A discount rate of 3% was used. Incremental cost-effectiveness ratios (ICERs) were presented as year 2009 values. A base-case analysis was performed for thalassaemia patients requiring regular blood transfusion therapy, while a separate analysis was performed for patients requiring low (i.e. symptom-dependent, less frequent) blood transfusion therapy. A series of sensitivity analysis and cost-effectiveness acceptability curves were constructed. Results: Compared with DFO, using DFP was dominant with lifetime cost savings of

Casemix adjustment for outpatient service: a tool for resource allocation of social security population in Thailand

US91 117. Comparing DFX with DFO, the incremental cost was

The adjusted clinical group (ACG) is adapted to predict costs of chronic disease

US522 863 and incremental QALY was 5.77 with an ICER of

Pattern of outpatient utilisation and cost for patients under the Universal Coverage

US90 648 per QALY. When compared with DFP, the ICER of DFX was

Outcomes of home health care and telephone home visit by pharmacist in type 2 diabetes patients on hospital readmission: a case study at Bangplama Hospital, Suphanburi Province, Thailand

US106445 per QALY. A cost-effectiveness analysis curve showed the probability of DFX being cost effective was 0% when compared with either DFO or DFP, based on the cost-effectiveness cut-off value of

Cost-effectiveness of care for type 2 diabetes patients in Nopparat Rajathanee hospital and private clinics

US2902 per QALY. When compared with DFP, DFX was cost effective only if the DFX cost was as low as

Hospitalisation by ambulatory care sensitive conditions at Rajavithi hospital, Bangkok

US1.68 per 250mg tablet. The results of the analysis in patients requiring low blood transfusion therapy were not different from those of the base-case analysis. Conclusions: Our findings suggest that using DFP is cost saving when compared with conventional therapy, while using DFX is not cost effective compared with either DFO or DFP in Thai patients with transfusiondependent b-thalassaemia. Policy-makers and clinicians may consider using such information in their decision-making process in Thailand.

Improving efficiency in financial process of the National Health Security Scheme

Address: 1Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand and Centre for Health Equity Monitoring, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand, 2Centre for Health Equity Monitoring, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand, 3National Health Security Office, Nonthaburi, Thailand and 4Social Security Office, Nonthaburi, Thailand

Cost-Utility Analysis of Intravenous Immunoglobulin for the Treatment of Steroid-Refractory Dermatomyositis in Thailand

Methods A retrospective study included 2,433,027 patients attending 22 large general and provincial hospitals. Data, including diagnostic and resource utilization, were obtained over the one-year period of 2008. Hospital and pharmacy cost data for outpatients were obtained from a hospital-based computer system. The multiple linear regression technique was used for constructing the prediction model. The dependent variable was the natural logarithm of reimbursed money. The output that would result from replacing the ACG with the CCI variable was considered, and the two possible outputs were compared.

Economic Evaluation of Intravenous Immunoglobulin plus Corticosteroids for the Treatment of Steroid-Resistant Chronic Inflammatory Demyelinating Polyradiculoneuropathy in Thailand.

Materials and methods Outpatient data from the National Health Security Office in 2011 were analysed, 4 provinces were picked to represent the pattern of service utilisation. The selection criteria emphasised on 1) availability of various types of hospitals in the province (health promoting, community, general/ regional, university hospital; and others), and 2) the maximum utilisation rate of people in the province. Descriptive statistical analysis was employed to calculate annual utilisation. One-way analysis of variance was used to calculate the association between the annual costs per person and the pattern of service utilisation (whether rural or urban or both; and the type of hospital).