Different treatment strategies for Haemophilia A with Low Inhibitor

Abstract

Objective: To compare the cost-effectiveness of treatment options in three patients with haemophilia A and low titer inhibitors.

Methodology: We used a longitudinal before-and-after design that was conducted in two phases assessed retrospectively: Phase I was 6 months preceding the introduction of recombinant activated factor VII (rFVIIa), during which patients received on–demand usual care with plasma derived factor VIII regimes, phase two was 6 month treatment on rFVIIa. We determined the clinical response and the cost of treatment with NovoSeven in three patients with low titer inhibitors to factors VIII compared with other treatment regime previously used in these patients (Plasma derived factor VIII).

Results: Total number of bleeding episodes, re-treatments and need of hospitalization were 21, 11 and 12 in phase 1 vs. 19, 0 and 0 in phase two respectively. Total cost of rFVIIa and plasma derived factor VIII treatment was USD 98600 vs. USD 77000.

Conclusion: rFVIIa is clinically effective. It resulted in 100% reduction in the number of re-treatments, hospitalization and 21.9% reduction in the total cost compared to treatment with plasma derived factor VIII regime.