The direct costs of transfusion-dependent beta-thalassemia in Saudi Arabia: A cost of illness analysis study

Thalassemia is an inherited blood disorder that leads to significant mortality and morbidity. Saudi Arabia has one of the highest prevalences of thalassemia in the world, based on available data. The high prevalence in the country and the associated significant healthcare needs resulting from the disease certainly lead to major health costs, where there is currently a knowledge gap. This is a single-center, retrospective, prevalence-based, bottom-up approach to estimating the cost of illness for thalassemia major. Data on transfusion-dependent β-thalassemia (TDT) patients were collected through medical health records at a tertiary center in Saudi Arabia between 2018 and 2022. Direct costs were calculated by summing up the unit costs of each intervention multiplied by the number of episodes. A total of 152 β-thalassemia major patients were eligible for our study. The mean age was 17 years, 49% of the patients were female, and 72% were expatriates. The direct cost of TDT was estimated at $28,097.24 per patient-year. Most of these expenses were directed toward regular transfusion services and medications, primarily driven by the cost of chelation agents. Based on the most recent data on the prevalence of thalassemia in the population, the annual cost of thalassemia in Saudi Arabia is estimated at $393.3 million. TDT imposes a significant cost burden in Saudi Arabia, and the cost is likely to be exponentially higher if indirect expenses are incorporated. Ongoing national efforts in premarital testing and genetic counseling are expected to help reduce these costs.