Hemophilia A Factor VIII Prophylaxis Annual Cost Top $650K

Patients with hemophilia A that require factor VIII (FVIII) prophylaxis had a mean per-patient total annual all-cause health care cost of $654,571, according to a poster presented by Kelly Adamski, MPH, of Analysis Group, Inc., at AMCP 2021.

These costs ranged from as low as $650,065 to as high as $759,661 depending on the definition used to define the prophylaxis population. These data are from a study of patients aged 18 to 64 with hemophilia A and four or more medical or pharmacy claims for FVIII concentrate in a non-in-patient or non-emergency department setting during the last year or more on continuous commercial plan enrollment.

The researchers identified 411 adult, male patients who met the criteria; 401 had six or more FVIII dispenses (subgroup 1), 60 day or more maximum gap in supply (subgroup 2), 273 days or more of supply (subgroup 3); 222 patients met the inclusion criteria for all three groups.

Subgroup 1 had an all-cause total health care cost of $650,065; subgroup 2, $683,347; and subgroup 3, $759,661.

The cost of FVIII concentrate was the primary driver of these healthcare costs, accounting for more than 96% of total health care costs in the overall cohort and across three prophylaxis subgroups. The per-patient mean annual FVIII costs were highest among patients treated with both standard half-life and extended half-life FVIII ($784,945) followed by extended half-life FVIII only ($708,928), standard half-life only ($647,800), and plasma-derived FVIII ($535,614). The researchers noted that the costs reported did not reflect patients managed with emicizumab prophylaxis.

Among the group of patients with one or more non-in-patient/non-emergency department pharmacy claims, the most common all-cause health care utilization were outpatient visits (95%). Emergency department visits (27%), in-patient admissions (7%), and home health visits (7%) were used less frequently.

“This study highlights the impact of how definitions used will influence the estimates observed, particularly for conditions like hemophilia A,” the researchers wrote.

Adamski K, et al. Utilization and cost of prophylactic FVIII treatment among patients with hemophilia A. Poster D15. Presented at AMCP 2021; April 12-16, 2021.