{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T13:04:47Z","timestamp":1786367087260,"version":"build-2736575974"},"reference-count":25,"publisher":"Scientific Scholar","content-domain":{"domain":["nmji.in"],"crossmark-restriction":true},"short-container-title":["NMJI"],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background<\/jats:title>\n<jats:p>Treating beta-thalassaemia major may entail high costs with considerable out-of-pocket expenditure. Therefore, determination and valuation of the economic costs of a common haemoglobinopathy such as beta-thalassaemia major in India may provide insights to evolve policies for reduction or elimination of the disease. We estimated economic burden of beta-thalassaemia major in Mumbai in terms of cost to the family and the healthcare system.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This single-centre, prospective, cross-sectional, non-interventional study included children &lt;12 years of age treated at the thalassaemia day care centre of a public hospital in Mumbai. The demographic data and treatment-related information was recorded. Cost of illness was studied from a societal perspective by the prevalence-based approach. Direct (medical and non-medical), indirect (loss of wages and loss of school days) and intangible costs (closed-ended iterative bidding) were calculated for each patient by interview.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Results<\/jats:title>\n<jats:p>The total annual cost of treating 130 children with beta-thalassaemia major in Mumbai was \u20b986 72 412 (US$ 127 535) or \u20b966 710 (US$ 981) per patient per year and \u20b912 82 30 412 (US$ 1 885 741) including intangible costs. Direct costs contributed to 94% of the cost of illness with chelation therapy (23%) and blood investigations (21%) being major contributors. Direct and indirect costs correlated significantly with duration of blood transfusion (p&lt;0.05 and p=0.006, respectively), whereas indirect costs correlated with socioeconomic status (rho=0.25).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st4\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The majority (94%) of costs incurred by families for treatment of beta-thalassaemia major are direct costs, especially expenses for chelation and blood investigations. Even at subsidized rates, financial burden to the families from lower socioeconomic strata is likely to be considerable as these are out-of-pocket expenses. In consideration of the economic impact of treating beta-thalassaemia major in individual families, the healthcare system and society, it is prudent to promote and pursue long-term and short-term measures with urgent emphasis on prevention as a public health activity at the national level in India.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/nmji_580_20","type":"journal-article","created":{"date-parts":[[2023,7,20]],"date-time":"2023-07-20T14:17:25Z","timestamp":1689862645000},"page":"11-16","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Economic burden of beta-thalassaemia major receiving hypertransfusion therapy at a public hospital in Mumbai"],"prefix":"10.25259","volume":"36","author":[{"given":"ASHWIJA","family":"UCHIL","sequence":"first","affiliation":[{"name":"Department of Paediatrics, Seth GS Medical College and KEM Hospital, Parel, Mumbai 400012, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MAMTA","family":"MURANJAN","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Seth GS Medical College and KEM Hospital, Parel, Mumbai 400012, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"NITHYA J.","family":"GOGTAY","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology, Seth GS Medical College and KEM Hospital, Parel, Mumbai 400012, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2023,7,18]]},"reference":[{"key":"10.25259\/NMJI_580_20\/ref-2","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1186\/s12939-019-1001-7","article-title":"Out-of-pocket expenditure and distress financing on institutional delivery in India","volume":"18","author":"Mishra","year":"2019","journal-title":"Int J Equity Health"},{"key":"10.25259\/NMJI_580_20\/ref-3","doi-asserted-by":"publisher","first-page":"327","DOI":"10.3350\/cmh.2014.20.4.327","article-title":"Cost-of-illness studies: Concepts, scopes, and methods","volume":"20","author":"Changik","year":"2014","journal-title":"Clin Mol Hepatol"},{"key":"10.25259\/NMJI_580_20\/ref-4","doi-asserted-by":"publisher","first-page":"893","DOI":"10.1007\/BF02723953","article-title":"Burden of genetic disorders in India","volume":"67","author":"Verma","year":"2000","journal-title":"Indian J Pediatr"},{"key":"10.25259\/NMJI_580_20\/ref-5","first-page":"308","article-title":"Evaluation of the national health policy of thalassaemia screening in the Islamic Republic of Iran","volume":"11","author":"Ghotbi","year":"2005","journal-title":"East Mediterr Health J"},{"key":"10.25259\/NMJI_580_20\/ref-6","first-page":"24","article-title":"Psycho-social and economic impact of thalassemia major on patients' families","volume":"8","author":"Ishfaq","year":"2016","journal-title":"ISRA Med J"},{"key":"10.25259\/NMJI_580_20\/ref-7","doi-asserted-by":"publisher","first-page":"899","DOI":"10.1002\/pd.1035","article-title":"Cost-effectiveness of prenatal screening for thalassaemia in Hong Kong","volume":"24","author":"Leung","year":"2004","journal-title":"Prenat Diagn"},{"key":"10.25259\/NMJI_580_20\/ref-8","doi-asserted-by":"publisher","first-page":"1038","DOI":"10.1111\/trf.13513","article-title":"Healthcare costs and outcomes of managing \u00e2thalassemia major over 50 years in the United Kingdom","volume":"56","author":"Weidlich","year":"2016","journal-title":"Transfusion"},{"key":"10.25259\/NMJI_580_20\/ref-9","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1186\/1756-0500-3-29","article-title":"Economic burden of beta-thalassemia\/Hb E and beta-thalassemia major in Thai children","volume":"3","author":"Riewpaiboon","year":"2010","journal-title":"BMC Res Notes"},{"key":"10.25259\/NMJI_580_20\/ref-10","doi-asserted-by":"publisher","first-page":"A323","DOI":"10.1016\/j.jval.2014.08.1661","article-title":"The economic burden of treating thalassemia in Greece","volume":"17","author":"Geitona","year":"2014","journal-title":"Value Health"},{"key":"10.25259\/NMJI_580_20\/ref-11","doi-asserted-by":"publisher","first-page":"185","DOI":"10.4103\/0970-0218.116358","article-title":"Modified Kuppuswamy's socioeconomic scale: Social researcher should include updated income criteria","volume":"38","author":"Bairwa","year":"2013","journal-title":"Indian J Community Med"},{"key":"10.25259\/NMJI_580_20\/ref-12","article-title":"WHO guide to identifying the economic consequences of disease and injury","year":"2009"},{"key":"10.25259\/NMJI_580_20\/ref-13","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1007\/s12098-018-2642-z","article-title":"Economic burden of transfusion dependent thalassemia","volume":"85","author":"Choudhry","year":"2018","journal-title":"Indian J Pediatr"},{"key":"10.25259\/NMJI_580_20\/ref-14","first-page":"113","article-title":"Endocrine complications in thalassemias. 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