Economics of Sickle Cell Disease and Evidence to Support Comprehensive Care

SCD causes lifelong acute and chronic complications that can have extensive detrimental effects on the lives of people living with the disease.60 Lee and colleagues recognized SCD care as an urgent public health need requiring the support of comprehensive SCD centers to coordinate the care of these high-risk patients.13 Americans with SCD are more likely to be socio-economically disadvantaged and have public health insurance as their primary payor.13,25 Paradoxically, those with commercial insurance may be at a disadvantage in having access to novel SCD therapies due to insurance company denial of coverage for medication or treatment costs. This paper describes financial and nonfinancial economic considerations of comprehensive SCD care. SCD economics should not be restricted to the basic factors of health care resource utilization and cost as a means to quantify the importance of outcome measures such as mortality and health-related quality of life. Further, the well-known and often ignored racism, bias and inequity that permeates the care of patients with SCD can adversely affect patient outcomes. Comprehensive SCD care models attempt to address these concerns that are not discussed here but are addressed elsewhere. The value may be a preferable framework when evaluating SCD comprehensive care models' ability to effectively deliver high-quality, equitable, and economically sound SCD care.

Automated summary

SCD causes lifelong complications and patients often face socioeconomic disadvantages. Comprehensive SCD centers are needed to coordinate care for high-risk patients. Commercial insurance may not cover novel SCD therapies, leading to inequitable access to treatment. Understanding the economic and nonfinancial aspects of SCD care is important for evaluating comprehensive care models.