Sickle Cell Cure Would Have Wide-Ranging Economic Impacts, Study Finds

Finding a cure for sickle cell disease (SCD) would have a dramatic economic impact, not only on the lives of patients, but also on the broader economy, according to the authors of a new study.

The report, based on models of expected earnings, was published as a letter to the editor in the American Journal of Hematology.

As screening programs and penicillin prophylaxis have been implemented into the health care system, patients with SCD have seen significant increases in life expectancy. Still, corresponding author Marlon Graf, PhD, of the consulting firm Precision Health Outcomes & Economics Research, and colleagues explained that people with SCD still face significant economic disadvantages. For instance, they can be expected to earn nearly $700,000 less than matched peers in their lifetimes due to their shorter life expectancy alone.

Yet, to date there have not been any studies that have looked at how a cure might impact the earning potential of patients with SCD, as well as how that change might affect wider economic disparities. The investigators noted that Black and Hispanic people in the United States are disproportionately affected by SCD, and those groups also tend to have poorer educational and economic outcomes.

Graf and colleagues constructed a model to see how a theoretical individual with SCD might experience increased productivity and earnings if a future genetic therapy were able to cure his disease. They created a nationally representative sample of 6352 people based on participants in a child development survey published in 1997. Half of the sample had SCD and half did not.

The model showed people with SCD would earn 42-46% less per year than the healthy controls, with lifetime earnings 59-66% lower, based on net present economic values.

However, if a cure were invented and patients received it before high school, their earnings would be just 8% less than the healthy comparison group, and lifetime earnings would be just 5-7% lower than the non-SCD group.

If a person were cured during or after high school, their earnings would also increase, with their total lifetime earnings more than doubling.

When the investigators looked specifically at the effects of curing SCD on Black Americans specifically, they found Black Americans with SCD would see their annual median income increase from $25,442 to $38,618. The current median income for the general Black American population is $45,438. They found that the number of Black Americans with SCD who earned less than the federal poverty line would drop by 5% from 28.6% to 23.4%. The current poverty rate among the overall Black American population is 20.8%, they said. The gap in lifetime earnings would also narrow.

Graf and colleagues said their study should be read in context, noting that the economic improvements they modeled would not erase economic disparities between different demographic groups of Americans. However, they said their data show how a cure would offer immediate economic improvement, which would translate into longer-term impacts as people with SCD were able to pursue educational and career opportunities like their peers without SCD.

“It is also possible [the] benefits of a cure may have generational impact: lifelong benefits for an individual may help future generations close income gaps, although this has not been formally explored here,” they added.

The authors concluded that their model shows how finding a cure for SCD would pay long-term dividends, both in terms of health and in terms of economic growth.

Reference:

Graf M, Tuly R, Gallagher M, Sullivan J, Jena AB. Value of a cure for sickle cell disease in reducing economic disparities. Am J Hematol. Published online May 23, 2022. doi:10.1002/ajh.26617