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Haemophilia. 2017 Jul;23(4):e267-e275. doi: 10.1111/hae.13220. Epub 2017 Jun 2.

Real-world resource use and costs of haemophilia A-related bleeding.

Author information

1
Precision Health Economics, Los Angeles, CA, USA.
2
Biogen, Cambridge, MA, USA.
3
University of Southern California, Los Angeles, CA, USA.
4
Wake Forest University School of Medicine, Winston-Salem, NC, USA.

Abstract

INTRODUCTION:

Prophylaxis treatment is recommended for haemophilia patients, but associated real-world economic costs and potential cost-savings associated with improved disease management are not fully known. This study aimed to assess haemophilia A-related resource use and cost by treatment type (prophylaxis versus non-prophylaxis) and any associated cost-savings.

METHODS:

Truven MarketScan Commercial claims data (2004-2012) were used to identify haemophilia A-related healthcare utilization, healthcare costs and patterns of prophylaxis and non-prophylaxis treatment among 6- to 64-year-old males. We estimated bleeding-related resource utilization and costs in three age groups (6-18, 19-44, 45-64) by treatment types and assessed the extent to which early initiation of prophylactic treatment can mitigate them. T-tests and ordinary least squares regressions were used to compare unadjusted and demographics-adjusted cost estimates.

RESULTS:

Among children, overall haemophilia- and bleeding-related non-pharmacy costs were substantially lower for patients receiving prophylaxis (haemophilia-related: $15,864 vs. $53,408; P < 0.001; bleeding-related: $696 vs. $2013, respectively; P = 0.04). Among younger adults (19-44), haemophilia-related non-pharmacy costs were lower for patients receiving prophylaxis ($22,028 vs. $56,311, respectively; P = 0.001). Among children, these savings fully offset the incremental pharmacy cost due to prophylaxis. Among younger adults, the savings offset approximately 34% of the incremental pharmacy cost. No differences were found for older adults (45-64).

CONCLUSION:

These results suggest that initiating prophylaxis earlier in life may reduce the healthcare costs of bleeding events and their long-term complications. Future studies should strive to collect more detailed information on disease severity and treatment protocols to improve estimates of disease burden.

KEYWORDS:

claims data; cost; haemophilia A; real-world data; resource use; treatment cost; utilization

PMID:
28574162
DOI:
10.1111/hae.13220
[Indexed for MEDLINE]

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