Cost of Managing a Painful Vaso-Occlusive Crisis at National Center for Research and Care for Sickle Cell Patients of Lomé in 2024

Introduction: Despite reduced fees, many patients struggle to access care at the National Center for Research and Care for Sickle Cell Patients (CNRSD). This prompted an evaluation of the costs associated with managing a painful vaso-occlusive crisis (VOC), the most common reason for hospitalization among individuals with sickle cell disease. Methods: This was a cross-sectional study which was conducted among patients admitted to the CNRSD for painful VOC. Costs were calculated in CFA francs (XOF), encompassing consultation fees, medication expenses, laboratory test costs, and hospitalization charges. The total cost per patient was derived by summing these components. Results: The study included 300 patients with a median age of 16.5 years. Most were children and adolescents (61.33% were under 20 years of age) with an SS genotype (64%). The average length of hospital stay was 3.1 days, with variations based on genotype. The median cost of managing a VOC episode was 64,130 XOF (€97.77), with 66.5% of this expenditure attributable to medications and consumables. Costs were influenced by age and genotype but were not associated with the presence of comorbidities. Notably, 67.33% of patients reported no fixed monthly income, significantly hindering their ability to afford care. Conclusion: The cost of managing a painful VOC episode is relatively high, exceeding the minimum wage in Togo. The lack of universal health insurance coverage exacerbates the difficulty for individuals with chronic conditions, such as sickle cell disease, to access quality care.