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Real‐world resource use and costs of haemophilia A‐related bleeding
Author(s) -
Shrestha A.,
EldarLissai A.,
Hou N.,
Lakdawalla D.N.,
Batt K.
Publication year - 2017
Publication title -
haemophilia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.213
H-Index - 92
eISSN - 1365-2516
pISSN - 1351-8216
DOI - 10.1111/hae.13220
Subject(s) - medicine , haemophilia , pharmacy , haemophilia a , health care , pediatrics , emergency medicine , demographics , intensive care medicine , demography , family medicine , economics , economic growth , sociology
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.