Healthcare costs among patients with hemophilia A treated with factor replacement or bypassing agents. (3rd August 2019)

• Record Type: Journal Article
• Authors: Swindle, Jason P.; Xu, Yaping; Mu, Yunming; Solari, Paul G.
• Is Part Of: Current medical research and opinion. Volume 35:Number 8(2019)
• Page Start: 1433
• Page End: 1440
• Publication Date: 2019-08-03
• Subjects: Hemophilia A -- bypassing agents -- FVII replacement -- healthcare costs; Clinical medicine -- Periodicals; Therapeutics -- Periodicals; 615.5
• DOI: 10.1080/03007995.2019.1596437
• Languages: English
• ISSNs: 0300-7995

Abstract

Abstract: Objective: To assess real-world costs for patients with hemophilia A treated with bypassing agents versus factor VIII (FVIII) replacement. Methods: Claims data from a large US health insurer during 1 January 2006–30 September 2014 were used for analysis. Treated patients with hemophilia A were identified based on ≥1 medical claim with a diagnosis code for hemophilia A (ICD-9-CM 286.0) and ≥1 medical or pharmacy claim for bypassing therapy and/or FVIII replacement during 1 January 2007–31 August 2014. The bypassing therapy cohort comprised patients with ≥1 claim for bypassing therapy; all others were assigned to the factor replacement therapy cohort. Post-index hemophilia-related costs were computed as combined health plan plus patient paid amounts for medical claims with hemophilia A diagnosis code or hemophilia therapy procedure code (bypassing therapy, FVIII replacement therapy, desmopressin, antifibrinolytic therapy), as well as pharmacy claims for hemophilia therapy. Results: The study sample represented 580 patients: 50 (8.6%) in the bypassing therapy cohort (mean age: 38.5 years; mean post-index period: 2.1 years) and 530 (91.4%) in the factor replacement therapy cohort (mean age: 29.3 years; mean post-index period: 2.7 years). Compared with the factor replacement therapy cohort, mean per-patient-per-month hemophilia-related total costs were 4.8-fold higher in the bypassing therapy cohort ($57, 232 vs. $11, 899), comprising 4.4-fold higher medical costs ($45, 911 vs. $10, 352) and 7.3-fold higher outpatient pharmacy costs ($11, 321 vs. $1547). Conclusions: Patients with hemophilia A treated with bypassing agents between 2007 and 2014 incurred substantially higher monthly hemophilia-related medical and pharmacy costs than patients treated only with FVIII replacement.