Cypriot thalassaemia patients are on the verge of receiving the drug Reblozyl through the General Health System (GHS), on a day marking the world’s highest per-capita rate of the condition — with one in every seven Cypriots a carrier.
Today marks World Thalassaemia Day. More than 1,300 people in Cyprus are living with the disease, approximately half of whom require regular blood transfusions, according to Miltos Miltiadous, president of the Pan-Cyprus Thalassaemia Association.
Reblozyl has been internationally described as a breakthrough treatment. It does not cure beta-thalassaemia and is not a gene therapy, but helps the body produce more mature and functional red blood cells, reducing the need for transfusions in a significant number of patients.
The drug is approved in both Europe and the United States for adult patients with beta-thalassaemia requiring regular transfusions. The EU has also approved its use in adults with non-transfusion-dependent beta-thalassaemia.
It is also used in certain forms of myelodysplastic syndromes. Approval was based in part on the large-scale BELIEVE clinical trial, which showed that a significant proportion of beta-thalassaemia patients were able to meaningfully reduce their transfusion needs.
“We remember the friends we lost”
Miltiadous told Phileleftheros that 8 May held particular significance for people living with thalassaemia. “It is the day we remember our parents’ efforts to secure the basics for us to be able to live, at a time when there was no blood and no medication. We remember the friends we lost and the luck of still being here,” he said.
He described thalassaemia as effectively Cyprus’s “national disease” — rare in most countries but a defining public health reality for the island. “One in seven Cypriots is a carrier, making Cyprus the country with the highest proportion of thalassaemia patients in the world,” he said.
He said this year’s World Thalassaemia Day found the community facing critical challenges, including blood supply adequacy and staffing at Thalassaemia Clinics, but that new developments offered grounds for optimism. “The imminent inclusion of Reblozyl in the GHS, along with progress in the field of gene therapy, makes us hopeful for the future,” he said.
On Reblozyl specifically, Miltiadous said its inclusion in the GHS was a development the association had been seeking for years. “Not because we believe in magic solutions, but because this is real progress that can improve the daily lives of patients for whom it can bring significant benefit. Fewer transfusions mean less iron overload, fewer complications and more time living outside hospitals,” he said.
A significant financial question
Olga Pitsilidou, a pharmacoeconomist at the Health Insurance Organisation (HIO), which administers the GHS, told Phileleftheros that Reblozyl’s reimbursement through the GHS was both a significant policy and economic matter.
“Reblozyl reduces the transfusion burden in eligible patients, potentially reducing iron overload and thus improving quality of life,” she said. However, she stressed that these benefits came with significant financial implications for a small healthcare system.
Published budget impact analyses have estimated that reimbursing Reblozyl could generate significant additional expenditure over a five-year horizon, representing a non-negligible share of GHS spending on innovative medicines, she said.
She also pointed to uncertainty surrounding the treatment’s long-term duration and the extent of cost offsets related to the reduction in transfusions and complications.
“The discussion on reimbursement extends beyond the clinical value of a single treatment and represents a broader paradigm for how Cyprus will manage future high-cost innovative medicines, while balancing equitable patient access with fiscal sustainability,” she said.
