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    Cost of hemophilia A in Turkey: an economic disease burden analysis
    (Taylor & Francis Ltd, 2021) Malhan, Simten; Oksuz, Ergun; Antmen, Bulent; Ar, Muhlis Cem; Balkan, Can; Kavakli, Kaan
    Objective: Hemophilia A is the second most common bleeding disorder causing patients to have lifelong follow-up and treatment. Despite being a rare disease, hemophilia A has a high economic burden on individuals and the public. The purpose of this study was to estimate the total disease cost of hemophilia A in Turkey. Materials and Methods: Data used in this analysis were collected through literature review, including studies conducted in Turkey in December 2018. A disease burden analysis was performed by modeling hemophilia A-related costs among patients, their relatives, and the social security system. Two expert panels were held to evaluate real-world data sources and to provide further information. All direct medical and non-medical costs were calculated annually from the Social Security Institution of the Republic of Turkey perspective, while indirect costs were estimated from the patient and community perspective. Results: For the calendar year of 2018, the number of hemophilia A patients in Turkey were estimated to be 5,055, with an average weight of 64.7 kg. The average annual direct medical, direct non-medical, and indirect costs of hemophilia A were calculated as euro93,268 ($109,286; (sic)502,717), euro2,533 ($2,968; (sic)13,655), and euro7,957 ($9,323; (sic)42,888) per patient, respectively, with a total annual cost of euro103,759 ($121,578; (sic)559,259). For the management of patients with inhibitors (4.9%), the average annual total cost was calculated to be euro325,439 ($381,330; (sic)1,754,117) per patient. The total annual disease burden of hemophilia A in 2018 was estimated to be about euro524 million ($614 million; (sic)2.82 billion), which corresponded to 1.6% of the total health expenditure in Turkey. Conclusion: The most important reason hemophilia A has a significant economic burden in Turkey is that replacement therapy is expensive. The major cost contributor was identified as factor replacement therapy. With inhibitor development, the average annual cost increased more than 3-fold.
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    The Cost-effectiveness of National Lung Cancer Screening in Türkiye
    (Kare Publishing, 2024) Malhan, Simten; Goksel, Tuncay; Karadurmus, Nuri; Kavakli, Kuthan; Savas, Recep; Sendur, Mehmet Ali Nihat; Simsek, Gokcen
    OBJECTIVE The aim of this study is to analyze the cost-effectiveness of the national lung cancer screening program in T & uuml;rkiye. METHODS In this cost-effectiveness model, the most likely protocol to be used after implementing a lung cancer survey for T & uuml;rkiye, the NELSON protocol, was used to make a comparison with the "no screening" case. This protocol involves individuals screened using low-dose computed tomography (LDCT). The model is anticipated to simulate 14 screening rounds, assuming an age range of 50-74 for lung cancer and 58 years for the screening program participants. The main outputs of the model were total life years gained (LYG), quality-adjusted life years (QALYs) gained in the screening arm, and the incremental cost-effectiveness ratio (ICER). RESULTS The analyses revealed a total QALY gained in the screening arm of 12,465,801 vs. a QALY gained of 12,149,148 in the comparator no screening arm. The incremental QALY value was estimated to be 316,654. The total LYG were 15,954,511 and 15,370,671 in the screening and no screening arms, respectively, resulting in an incremental LYG of 583,840. With lung cancer screening, stage III and IV cancer were identified in earlier phases in 13,636 cases. Prevented early deaths were 7,576. For the lung cancer screening program, the cost per QALY is $571, and the cost per LYG is $310. CONCLUSION Based on the results, implementation of the national lung cancer screening program was found to be very cost-effective for T & uuml;rkiye.