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

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.

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.

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.

The analysis confirms the advantages offered by prophylaxis with rFVIIIFc from an economic standpoint for the Greek healthcare system, in accordance with other studies.