A cost-utility analysis was performed desferrioxamine treatment in thalassaemia patients at two tertiary hospitafs in Malaysia in 2004. A hundred and twelve transfusion dependent thalassaemia patients were grouped according to the status of desferrioxamine; optimum and sub-optimum. Cost analysis was from a patient and hospital perspectives while Quality Adjusted Life Years (QALYs) was the health outcome of choice. Incremental Cost-Effectiveness Ratio (ICER) was afso stipulated to show the difference in cost for an additional QALY if patient currently on sub-optimum desferrioxamine to switch using optimum desferrioxamine. Results on cost analysis slwwed the mean cost of treatment for thalassaemia patients on optimum desferrioxamine was higher than those on sub-optimum desferrioxamine; (RM14,775.00+SD RM4, 737.00 and RMlO, 780+RM3,655, respectively). QALYs were 19.186+6.591 and 9.859+5.275 in the optimum and sub.optimum group, respectively. Cost-utility analysis showed the cost per QALYs in optimum desferrioxamine group was RM59,045.00 compared to RM44,665.00 in sub-optimum desferrioxamine group. ICER of patients on sub-optimum desferrioxamine switching to optimum desfemoxamine was only RM420.39. Sensitivity analysis showed that the results were robust in the best and worst scenarios. In condusion, although it is expensive for thalassaemia patients to use optimum desfemoxamine compared to sub.optimum desferrioxamine, the cost per QALYs gained was undoubtedly low.