• This study compared the costs of SHL, EHL and high-sustained FVIII products for surgical management in people with severe hemophilia A. • The high-sustained FVIII therapy efanesoctocog alfa resulted in 3 to 5. 5 times fewer IU/Kg and may save 38, 947 to 81, 000 per surgery. We estimated total costs for perioperative hemostatic management with standard half-life (SHL), extended half-life (EHL) and high-sustained (efanesoctocog alfa) factor VIII (FVIII) products in people with severe hemophilia A. The data on dose, total factor consumption and target FVIII activity for major surgeries were collected from United States (US) prescribing information and phase 3 clinical trials. The differences in the total factor consumption and total costs between therapies were compared. The median total factor consumption per major surgery involving octocog alfa (SHL), rurioctocog alfa pegol (EHL), efmoroctocog alfa (EHL) and efanesoctocog alfa was 910, 629, 493 and 163 IU/Kg, respectively. The total factor costs were 162, 308, 147, 104, 120, 233 and 81, 286, respectively. Efanesoctocog alfa resulted in 81, 022 to 38, 947 savings versus SHL/EHL therapies per surgery. The perioperative management with efanesoctocog alfa was estimated to be markedly more economical than that with SHL and EHL therapies due to its high-sustained factor activity.
Staber et al. (Sun,) studied this question.