Switching hemophilia A patients to an extended half-life agent on a prophylactic basis: an economic appraisal

BACKGROUND: Gaining an understanding of transitioning hemophilia patients to an extended half-life (EHL) agent requires real-world data, encompassing various outcomes, which would help assessing the impact of the switch, for patients and the healthcare system. We investigate the economic implications of switching from standard half-life (SHL) recombinant factor VIII (rFVIII) from either prophylaxis or on-demand, to EHL rFVIII efmoroctocog alfa (FVIIIFc) prophylaxis. RESEARCH DESIGN AND METHODS: The study involved 48 patients with hemophilia A from the 5 specialized hemophilia centers in Greece. Patients switched from prophylactic or on-demand treatment using a SHL factor VIII to a rFVIIIFc on prophylaxis only. Data was gathered for the 12-month period before and after switch. Using standard t-tests and regression analysis, we compared the direct treatment cost between the pre and post switch time, focusing on regimens' differential costs. RESULTS: There is no statistically significant cost increase compared to the core rFVIII regimen used before the switch, when only patients that were previously on prophylaxis were considered. However, there is a statistically significant reduction in cost across treatment styles. CONCLUSIONS: The analysis confirms the advantages offered by prophylaxis with rFVIIIFc from an economic standpoint for the Greek healthcare system, in accordance with other studies.