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

Osborne, Richard, De Abreu Lourenço, Richard, Dalton, Andrew, Houltram, Jennifer, Dowton, David, Joshua, Douglas, Lindeman, Robert and Ho, Phoebe 2007, Quality of life related to oral versus subcutaneous iron chelation: a time trade-off study, Value in health, vol. 10, no. 6, pp. 451-456.

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Title Quality of life related to oral versus subcutaneous iron chelation: a time trade-off study
Author(s) Osborne, Richard
De Abreu Lourenço, Richard
Dalton, Andrew
Houltram, Jennifer
Dowton, David
Joshua, Douglas
Lindeman, Robert
Ho, Phoebe
Journal name Value in health
Volume number 10
Issue number 6
Start page 451
End page 456
Publisher Wiley - Blackwell
Place of publication Malden, Mass.
Publication date 2007-11
ISSN 1098-3015
1524-4733
Keyword(s) administration route
iron chelation
quality of life
time trade-off
Summary 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.
Language eng
Field of Research 110399 Clinical Sciences not elsewhere classified
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2007, International Society for Pharmacoeconomics and Outcomes Research (ISPOR)
Persistent URL http://hdl.handle.net/10536/DRO/DU:30019414

Document type: Journal Article
Collection: School of Health and Social Development
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