A cost-effectiveness analysis of the prophylaxis versus on-demand regimens in severe hemophilia A patients under 12 years old in southern Iran

Figures & data

Table 1. Transition probabilities amongst the states in the PR and OD regimens.

Transition probabilities	PR	OD
Alive to alive	0.979	0.935
Alive to alive with target joint	0.016 [38]	0.06 [38]
Alive to dead	0.005 [39]	0.005 [39]
alive with target joint to alive	0.714 [38]	0
alive with target joint to alive with target joint	0.285 [38]	0.995
alive with target joint to dead	0.005 [40]	0.005 [39]

Figure 1. The model structure and different states of the HA patients.

Table 2. The average DMCs and DNMCs and ICs of studied patients by the regimens ($PPP).

Costs		Prophylaxis			On-Demand
		$PPP	%	% of Total Costs	$PPP	%	% of Total Costs
DMCs	Physicians’ Visits	24.95	0.06	94.30	62.04	0.17	98.16
	Medical Equipment	259.62	0.62		161.84	0.44
	Nursing Services^1	15.92	0.04		3.85	0.01
	Diagnostic Services	638.47	1.53		124.51	0.34
	Clotting Factors	40355.45	96.40		36133.78	98.74
	Other Medicines	84.67	0.20		40.64	0.11
	Other (including psychological counseling, genetic counseling, etc.)	483.28	1.15		67.07	0.18
	Total	41862.36	100		36573.73	100
DNMCs	Accommodation and Meals	481.03	37.29	2.91	98.54	37.43	0.71
	Transportation	809.06	62.71		164.72	62.57
	Total	1290.09	100		263.26	100
ICs	Total Productivity loss	1240.40	100	2.79	421.33	100	1.13
Total Costs ($PPP)		44392.85	100	100	37258.32	100	100

1. Including health care and injections, family education, etc.

Figure 2. Comparison of the Cost-Effectiveness of the prophylaxis versus on–demand regimens in patients with Hemophilia A Based on the QALY.

Table 3. Comparison of the cost-effectiveness of two studied regimens in Hemophilia A based on the number of QALY using the Markov model.

Regimens	Cost (PPP$)	QALY	Incremental Cost (PPP$)	Incremental QALY	ICER (Incremental cost per QALY Gained)	Subset
Prophylaxis (PR)	478,963.1	11.98	0.00	0.00	0.00	Dominant
On–demand (OD)	521,797.2	10.99	42,834.12	−0.98	−43630.1	Dominated

ICER: Incremental Cost-Effectiveness Ratio; QALY: Quality Adjusted Life Year.

Figure 3. The incremental cost-effectiveness scatter plots of the PR versus OD based on the QALY.

Figure 4. Cost-effectiveness acceptability curve obtained through Monte Carlo Simulation for hemophilia A patients, under-12-years-old in southern Iran.

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