The effects of economic sanctions on disease specific clinical outcomes of patients with thalassemia and hemophilia in Iran

Background: The sanctions applied by both the USA and the EU against Iran do not formally ban the exports of medicines; in practice, however, patients are experiencing great difficulty in securing the treatment. This article documents the impact of international sanctions on patients with thalassemia and hemophilia in southern Iran. Methods: This survey examined the specific effects of external sanctions on the access of patients to their treatment between 2009 and 2012 from the point of view of patients with thalassemia (n=69) and congenital coagulation disorders (n=40) as well as related physicians (n=20). Also, clinical manifestation and laboratory data of patients were compared in the same period. Results: Access to deferoxamine and Exjade as iron chelators in patients with thalasseamia, respectively, declined by almost 70% and half over this period. In addition, access to lyophilized coagulation factor VIII concentrate in hemophilia A dramatically dropped from 96.7% in 2009 to 3.3% in 2012. The clinical results showed a significant deterioration of arthropathy (P < 0.001) in hemophiliac patients and a significant increase in serum ferritin levels in thalassemia patients (P = 0.036). Conclusion: Sanctions had significant effect on public health on patients with thalassemia and hemophilia. (C) 2014 Elsevier Ireland Ltd. All rights reserved.