Quality of life related to oral versus subcutaneous iron chelation: A time trade-off study

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Abstract

Objective: To investigate the utility associated with subcutaneous infusion (deferoxamine) compared with once-daily oral administration (deferasirox) of iron chelation therapy. Methods: Interviews using the time trade-off technique were used to estimate preferences (utility) for health states by finding the point at which respondents were indifferent between a longer but lower quality of life (QoL) and a shorter time in full health. Participants (n = 110) were community-based, 51% women, median age 35 years, from four regions in Sydney, Australia. Respondents rated three health states involving equal outcomes for people with thalassemia but with different treatment modalities for iron chelation; an "anchor state" describing a patient receiving iron chelation without administration mode specified, anchor state plus iron chelation via subcutaneous infusion, and anchor state plus iron chelation through once-daily oral medication. Results: On an interval scale between 0 (death) and 1 (full health), median (interquartile range) utility of 0.80 (0.65-0.95) for the anchor state, 0.66 (0.45-0.87) for subcutaneous infusion, and 0.93 (0.80-0.97) for once-daily oral administration was obtained. The mean (median) difference of 0.23 (0.27) between the two treatments was statistically significant (Wilcoxon-signed rank test, P < 0.001). Subcutaneous infusion was associated with a mean (median) utility 0.13 (0.14) lower than the anchor state (P < 0.001), and once-daily oral treatment had a utility 0.10 (0.13) higher (P < 0.001). Conclusion: Community respondents associate oral administration of an iron chelator such as deferasirox with enhanced QoL compared with subcutaneous treatment. Assuming equal safety and efficacy, QoL gains from once-daily oral treatment compared with subcutaneous infusion are significant. © 2007, International Society for Pharmacoeconomics and Outcomes Research (ISPOR).

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Osborne, R. H., De Abreu Lourenço, R., Dalton, A., Houltram, J., Dowton, D., Joshua, D. E., … Ho, P. J. (2007). Quality of life related to oral versus subcutaneous iron chelation: A time trade-off study. Value in Health, 10(6), 451–456. https://doi.org/10.1111/j.1524-4733.2007.00200.x

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