Economic burden of hemophilia A and B: a case in Iran

Figures & data

Table 1. Demographic characteristics of the studied hemophilia A and B patients.

		Hemophilia type
Demographic characteristics		Type A		Type B
		Frequency	%	Frequency	%
Age (years)	<10	30	15.55	3	5
	10–20	69	35.75	17	28.34
	20–30	51	26.42	13	21.66
	>30	43	22.29	27	45
Disease Severity	Severe	120	62.18	16	26.66
	Moderate	55	28.5	38	63.34
	Mild	18	9.32	6	10
Education	Illiterate	28	14.5	3	5
	Elementary School	19	9.84	5	8.33
	Guidance School	63	32.64	27	45
	High School	29	15.02	14	23.34
	Academic Degrees	54	28	11	18.33
Job	Employee	9	4.66	1	1.66
	worker	12	6.22	7	11.66
	Freelancer	27	13.99	27	45
	Retired	10	5.18	10	11.66
	Unemployed^a	135	69.95	15	25
Place of Residence	Urban	162	83.93	50	83.34
	Rural	31	16.07	10	16.66
Having Basic Health Insurance Coverage	Yes	192	99.48	58	96.66
	No	1	0.52	2	2.34
Type of Basic Health Insurance Coverage	Iran Health Insurance	52	26.96	11	18.33
	Social Security Health Insurance	138	71.50	47	78.33
	Armed Forces Medical Services Insurance	1	0.52	0	0
	Rural Health Insurance	1	0.52	0	0
Having Supplementary Health Insurance Coverage	Yes	8	4.15	6	10
	No	185	95.85	54	90
Covered by Supporting Entities	Yes	173	89.64	59	98.34
	No	20	10.36	1	1.66
Type of Supporting Entities	Hemophilia Association	146	75.64	58	96.67
	Imam Khomeini Relief Foundation	11	5.69	1	1.67
	Welfare Organization	8	4.14	0	0
	Charity Foundation for Special Diseases	8	4.14	0	0

Note: Including school and university students and unemployed people at the age of working.

Table 2. Mean annual direct and indirect costs of studied hemophilia A and B patients in 2017 (USD).

Costs\Severity		Hemophilia A								Hemophilia B
		Severe		Moderate		Mild		Total		Severe		Moderate		Mild		Total
		Mean	%	Mean	%	Mean	%	Mean	%	Mean	%	Mean	%	Mean	%	Mean	%
Direct Medical Costs	Clotting factor concentrates	47128	97.40	22192	96.62	3593	90.8	35961	97.12	39558	99.11	26921	98.41	22167	98.54	29815	98.67
	Injections and medical consumables^a	82	0.17	137	0.59	47	1.17	95	0.25	75	0.19	106	0.39	93	0.43	97	0.32
	Dental services	3	0.005	3	0.01	0	0	3	0.008	0	0	0	0	0	0	0	0
	Physiotherapy	22	0.04	8	0.02	0.92	0.33	18	0.048	21	0.05	34	0.12	0	0	27	0.09
	Specialist visits	106	0.22	513	2.22	57	1.45	217	0.58	100	0.26	56	0.20	43	0.2	66	0.22
	Laboratory tests	957	1.98	127	0.55	111	2.79	641	1.74	134	0.33	226	0.83	175	0.8	197	0.65
	Echocardiography	4	0.007	3	0.01	3	0.07	4	0.01	0	0	0	0	0	0	0	0
	Radiographies	35	0.07	14	0.06	17	0.43	28	0.07	23	0.06	12	0.05	6	0.03	15	0.05
	Hospitalization	46	0.10	71	0.34	116	2.96	60	0.17	0	0	0	0	0	0	0	0
	Total	48384	100	23071	100	3957	100	37027	100	39911	100	27355	100	30216	100	30217	100
Direct Non-medical Costs	Patient's transportation	328	60.78	232	72.02	220	65.55	290	63.23	347	73	261	82	278	71	285	77.63
	Patient’s companion's transportation	205	37.88	69	21.20	99	44.29	156	34.02	131	27	57	18	112	29	82	22.37
	Patient's meals and accommodation	2	0.34	4	1.25	6	1.81	3	0.63	0	0	0	0	0	0	0	0
	Patient’s companion's meals and accommodation	6	1	17	5.53	11	3.1	10	2.12	0	0	0	0	0	0	0	0
	Total	541	100	322	100	335	100	460	100	478	100	318	100	389	100	367	100
Indirect Costs	Patient's absence from work	184	81.33	50	80.98	125	71.61	141	80.4	199	77	1700	86	121	100	172	90.05
	Patient’s companion's absence from work	42	18.67	12	19.02	49	28.39	34	19.6	5	23	28	14	0	0	19	9.95
	Total	226	100	62	100	174	100	175	100	204	100	197	100	121	100	191	100

Note: Medical consumables such as bandages, syringes, sterile gas, etc.

Table 3. Mean annual direct and indirect costs of studied Hemophilia A and B patients in 2017 (USD).

	Costs
	Direct medical costs		Direct non-medical costs		Indirect costs		Total costs
Hemophilia type	Mean	%	Mean	%	Mean	%	Mean	%
A	37027	98.32	460	1.22	175	0.46	37661	100
B	30217	98.18	368	1.19	191	0.63	30775	100
Total	35412	98.29	438	1.21	179	0.5	36028	100

Table 4. Estimated total annual costs of Hemophilia patients in Iran in 2017 (USD).

Hemophilia type	Number of patients in the country	Direct medical costs	%	Direct non-medical costs	%	Indirect costs	%	Total economic costs
A	4950	373288566	97.84	5929177	1.55	2285957	0.61	381503701
B	1033	31213216	94.65	1224268	3.71	539140	1.61	32976624
Total	5983	404501782	97.59	7153445	1.72	2825097	0.69	414480324