Comparison of Cost Effectiveness between Measuring the Serum Erythropoietin Level and Reticulocyte Count for Monitoring Thalassemic Patients: A Note in Thai Beta Thalassemia/Hb E Subjects

Abstract

Iron deficiency anaemia and the thalassemia syndromes, a group of disorders resulting from inherited abnormality of globin chain production, are common causes of anaemia in Thailand, and in the Far East in general. Monitoring erythropoiesis in these patient is very important in evaluating the disease and the response to treatment. Recently, our group [1] has just reported the feasibility in using serum erythropoietin (EPO) for monitoring purposes in thalassemia and demonstrated that the determination of serum EPO can be an alternative choice in the follow up of these conditions. This study reports a cost effectiveness analysis comparing the recently reported radioimmunoassay (RIA) for serum EPO determination and the previously used tool, the reticulocyte count. The study reports a higher detection rate for ineffective erythropoiesis when using serum EPO determination, however, the increased sensitivity is at balanced by a higher unit cost. In this analysis, the cost effectiveness for serum EPO and reticulocyte are 208.33 and 50 baht/detection, respectively. ( 1 USD=42 baht ) Therefore, the reticulocyte count is more cost effective and is recommended for routine usage in our current medico-economic setting.

Keywords:

• Thalassemia
• Erythropoiesis
• Cost effectiveness
• Serum erythropoietin
• Reticulocyte count