OUT OF POCKET EXPENDITURE ON THALASSEMIA MAJOR AND ITS IMPLICATIONS ON THE HOUSEHOLD ECONOMICS
DOI:
https://doi.org/10.55519/JAMC-01-8332Abstract
Background: Pakistan faces a considerable burden of disease with regard to inherited blood disorder, i.e., Thalassemia Major. Its economic implications are least studied before, particularly when it comes to ascertaining a household’s out of pocket expense on treating the disease. This study was carried out to understand the current estimate of Out-of-pocket expenditure (OOP) expense and its implications on the household and livelihood, while seeking treatment for a child suffering from thalassemia. Methods: It was a descriptive cross-sectional study of 3 months’ duration. Patients were selected from Fauji Foundation Hospital (FFH) and Pakistan Institute of Medical Sciences (PIMS), through. The descriptive quantitative analysis and inferential analysis was carried through purposive sampling. Results: Treatment expense of entitled patients from FFH hospital (a public hospital which offers entitlement to the families of retired army personnel) was compared with that of non-entitled patients coming to PIMS (a public sector general hospital). Total expense incurred on treatment by the end of the month was PKR. 5000–10,000 (USD31-62) in FFH, while at PIMS, the total expense incurred on treatment by the end of the month was around PKR 80,000 (USD500). Around 37% families having an average monthly income of PkRs25000 (USD150) only, sold their livelihoods, 31% compromised on their children’s education expenses and 23% percent curtailed the health expenses of the other children. Conclusion: The out-of-pocket expenditure on treating TM is quite high and compels the families to borrow money and sell or mortgage their property, which puts a great deal monetary pressure given their socio-economic status. A practical solution would be to cover these families under the health safety net supported by the government.References
Sum G, Hone T, Atun R, Millett C, Suhrcke M, Mahal A, et al. Multimorbidity and out-of-pocket expenditure on medicines: a systematic review. BMJ Glob Health 2018;3(1):e000505.
Prinja S, Jagnoor J, Sharma D, Aggarwal S, Katoch S, Lakshmi PV, et al. Out-of-pocket expenditure and catastrophic health expenditure for hospitalization due to injuries in public sector hospitals in North India. PLoS One 2019;14(11):e0224721.
Paramore C, Vlahiotis A, Moynihan M, Cappell K, Ramirez-Santiago A. Treatment patterns and costs of transfusion and chelation in commercially-insured and Medicaid patients with transfusion-dependent β-Thalassemia. Blood 2017;130(Suppl 1):5635.
Reed-Embleton H, Arambepola S, Dixon S, Maldonado BN, Premawardhena A, Arambepola M, et al. A Cost-of-Illness analysis of β-Thalassaemia major in children in Sri Lanka–Experience from a tertiary level teaching hospital. BMC Pediatr 2020;20(1):257.
Reed-Embleton H, Arambepola S, Dixon S, Maldonado BN, Permawardhena A, Arambepola M, et al. A cost-of-illness analysis of β-Thalassemia major in children in Sri Lanka – experience from a tertiary level teaching hospital. BMC Pediatr 2020;20(1):257.
Muhammad R, Shakeel M, Rehman SU, Lodhi MA. Population-based genetic study of β-thalassemia mutations in Mardan Division, Khyber Pakhtunkhwa Province, Pakistan. Hemoglobin 2017;41(2):104–9.
Jiang F, Zuo L, Li D, Li J, Tang X, Chen G, et al. Molecular epidemiology and hematologic characterization of δβ-thalassemia and hereditary persistence of fetal hemoglobin in 125,661 families of greater Guangzhou area, the metropolis of southern China. BMC Med Genet 2020;21(1):43.
Ghafoor MB, Iqbal J, Muhammad G, Shahbaz M, Hussain GM, Saleem M. Awareness Regarding Thalassemia in General Population of Rahim Yar Khan, Pakistan. Health Sci 2020;9(6):79–84.
Lone T, Shakeel M, Bischler J, Marzi M. ‘Towards shock-responsive social protection: lessons from the COVID-19 response in Pakistan. Shock-responsive social protection responses during COVID-19. 2020.
Siddiqui SH, Ishtiaq R, Sajid F, Sajid R. Quality of life in patients with thalassemia major in a developing country. J Coll Physicians Surg Pak 2014;24(7):47–80.
Safdar S, Mirbahar A, Sheikh MA, Taseer IU, Mustafa A, Ali Z, et al. Economic burden of Thalassemia on parents of Thalassemic children: A multi-centre study. Pak J Med Res 2017;56(3):68–72.
Khan MR, Anwar S, Faizan M, Nosheen S. The Burden of Transfusion related Infections on Thalassemia Major Children. Pak J Med Health Sci 2017;11(3):882–6.
Esmaeilzadeh F, Ahmadi B, Vahedi S, Barzegari S, Rajabi A. Major thalassemia, screening or treatment: an economic evaluation study in Iran. Int J Health Policy Manag 2021;10:34172.
Shafie AA, Wong JHY, Ibrahim HM, Mohammed NS, Chhabra IK. Economic burden in the management of transfusion-dependent thalassaemia patients in Malaysia from a societal perspective. Orphanet J Rare Dis 2021;16(1):157.
Kotzeva A, Chen JM, Balijepalli C, Regulier E, Druyts E. Psy154-economic burden of beta-thalassemia: literature review. Value Health 2018;21:S462.
Yazdi-Feyzabadi V, Bahrampour M, Rashidian A, Haghdoost AA, Javar MA, Mehrolhassani MH. Prevalence and intensity of catastrophic health care expenditures in Iran from 2008 to 2015: a study onIranian household income and expenditure survey. Int J Equity Health 2018;17(1):44.
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