Prophylaxis and continuous infusion for hemophilia: can we afford it?

Little is known about the ideal factor regimen for hemophiliacs nor how treatment should be administered. A prospective multicenter study evaluated different dosage regimens and defined orthopedic outcomes, based on factor consumption and a comparison of prophylaxis with on-demand therapy. Prophylaxis led to better outcomes, whether joints were initially normal or previously affected. Factor use was substantially more costly if prophylaxis was used, but a major reduction could be achieved if continuous infusion were feasible.