A research team recently examined health care costs related to treatment of hemophilia A with factor VIII (FVIII) replacement compared with costs associated with the use of bypassing agents. The study results were reported in Current Medical Research and Opinion.
For this retrospective cohort study, researchers analyzed data from a US insurance claims database involving patients with hemophilia A and with claims during the period of January 1, 2007, through August 31, 2014. One cohort consisted of 50 patients with 1 or more claims for bypassing therapy. The other cohort included 530 patients with claims related to FVIII replacement and with no claims for bypassing therapy.
Costs associated with hemophilia therapy were analyzed at baseline and throughout the period following the patient’s index date, which was the date of the patient’s first claim in the database related to the cohort treatment. Health care cost outcomes included per-patient-per-month (PPPM) values, 1-year all-cause costs, and 1-year hemophilia-related costs.
The median postindex period lasted 531.5 days for the cohort using bypassing agents and 749.0 days for the FVIII replacement cohort.
During the postindex period, the bypassing therapy cohort showed significantly higher mean PPPM hemophilia-related total health care costs ($57,232 vs $11,899). These values were primarily attributed to mean PPPM medical costs of $45,911 for the bypassing therapy cohort and $10,352 for the FVIII replacement cohort. The remaining PPPM hemophilia-related total health care costs were attributed to outpatient pharmacy costs.
For patients enrolled 12 or more months after the index date, the mean 1-year all-cause total health care costs were $804,514 (median $198,175) for patients in the bypassing therapy cohort and $155,733 (median $69,819) for the FVIII replacement cohort.
Most all-cause total health care costs could be attributed to hemophilia-related care. The mean 1-year hemophilia-related total health care costs were $771,659 (median $153,442) for the bypassing therapy cohort and $138,002 (median $52,426) for the FVIII replacement cohort.
“Patients with hemophilia A who are treated with bypassing agents incurred considerably higher hemophilia-related medical and outpatient pharmacy costs than patients treated with factor replacement only,” the study authors stated in their report.
- Swindle JP, Xu Y, Mu Y, Solari PG. Healthcare costs among patients with hemophilia A treated with factor replacement or bypassing agents. Curr Med Res Opin. 2019;35(8):1433-1440.