Healthcare costs among patients with hemophilia A treated with factor replacement or bypassing agents |
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Authors: | Jason P. Swindle Yaping Xu Yunming Mu Paul G. Solari |
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Affiliation: | 1. Optum, Chicago, IL, USA;2. jason.swindle@optum.com;4. Genentech Inc., South San Francisco, CA, USA |
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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. |
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Keywords: | Hemophilia A bypassing agents FVII replacement healthcare costs |
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