Relative estimated cost of deferaprone, deferoxamine, and deferasirox*
. | Deferiprone† . | . | Deferoxamine‡ . | . | Deferasirox§ . | . | |||
|---|---|---|---|---|---|---|---|---|---|
. | 25-kg child . | 60-kg adult . | 25-kg child . | 60-kg adult . | 25-kg child . | 60-kg adult . | |||
| Moderate daily dose, mg/kg | 75 | 75 | 25 | 25 | 20 | 20 | |||
| Annual cost, $ | |||||||||
| United States | NA | NA | 6 760 | 16 220 | 16 270 | 39 000 | |||
| India | 350 | 840 | ND | ND | NA | NA | |||
| Italy | 2 790 | 6 700 | 1 670 | 4 020 | NA | NA | |||
| Higher daily dose, mg/kg | 100 | 100 | 40 | 40 | 30 | 30 | |||
| Annual cost, $ | |||||||||
| United States | NA | NA | 10 810 | 25 952 | 24 400 | 58 500 | |||
| India | 470 | 1 120 | ND | ND | NA | NA | |||
| Italy | 3 720 | 8 940 | 2 680 | 6 430 | NA | NA | |||
. | Deferiprone† . | . | Deferoxamine‡ . | . | Deferasirox§ . | . | |||
|---|---|---|---|---|---|---|---|---|---|
. | 25-kg child . | 60-kg adult . | 25-kg child . | 60-kg adult . | 25-kg child . | 60-kg adult . | |||
| Moderate daily dose, mg/kg | 75 | 75 | 25 | 25 | 20 | 20 | |||
| Annual cost, $ | |||||||||
| United States | NA | NA | 6 760 | 16 220 | 16 270 | 39 000 | |||
| India | 350 | 840 | ND | ND | NA | NA | |||
| Italy | 2 790 | 6 700 | 1 670 | 4 020 | NA | NA | |||
| Higher daily dose, mg/kg | 100 | 100 | 40 | 40 | 30 | 30 | |||
| Annual cost, $ | |||||||||
| United States | NA | NA | 10 810 | 25 952 | 24 400 | 58 500 | |||
| India | 470 | 1 120 | ND | ND | NA | NA | |||
| Italy | 3 720 | 8 940 | 2 680 | 6 430 | NA | NA | |||
AWP indicates average wholesale price; NA, not available; and ND, not determined for this review.
No published data compare contemporaneous costs in a single country. Deferasirox is available with commercial pricing in the United States only, whereas deferiprone is not available in the United States.
Deferiprone monitoring includes weekly CBC/differential count compared with monthly CBC for the other drugs; this adds more than $1000 to the annual drug cost at United States prices. India cost $0.272/500 mg33 ; Italy wholesale $2.04/500 mg. Costs based on exchange rates 47 rp/$US and $US1.20/Euro.
Italian costs courtesy of Pharmacy, University of Ferrarà, Italy.
Generic DFO became available after the 2003 Redbook was released. The price now ranges from well below $14/500 mg for generic DFO to more than $20/500 mg for brand name (US AWP $14.81/500 mg vial, without infusion ancillaries; Italy wholesale $3.67/500 mg). Neither discounts nor markups to AWP are considered for these estimates. Infusion costs (pumps, needles, tubing, diluent) vary widely among United States payers and among states and countries and could add up to a few thousand dollars annually to DFO costs.
Price information (AWP $89/g) courtesy of Novartis Medical Affairs and cited in Cost Effectiveness abstract.34