Advertisement

Pharmacy World & Science

, Volume 30, Issue 3, pp 287–292 | Cite as

Cost-of-illness study of severe haemophilia A and B in five French haemophilia treatment centres

  • Virginie Nerich
  • Edgar Tissot
  • Albert Faradji
  • Karine Demesmay
  • Marie Anne Bertrand
  • Jean-Louis Lorenzini
  • Marie-Elisabeth Briquel
  • Patricia Pouzol
  • Marie-Christine Woronoff-LemsiEmail author
Research Article

Abstract

Objective The aim of this study was to assess the consumption of anti-haemophilic drugs by adults and children with severe haemophilia A or B (residual activity of FVIII or FIX ≤2%) and to quantify the average direct medical costs. Method A retrospective multicentre cost-of-illness study from the perspective of French national health insurance system. The costs include only the use of clotting factors. Main outcome measure Consumption was expressed in UI/kg/year and costs in euros/kg/year. Results From January 1, 2001 to December 31, 2002, data from 81 adults and 30 children with severe haemophilia A (n = 92) or B (n = 19) and included in the “SNH” were collected and analysed. A coagulation factor inhibitor was present in 10 patients (9%). Four of them were high responders. Mean age and body weight were respectively 28 ± 17 years and 58 ± 24 kg. Except for one adult patient, all (99%) had outpatient treatment, 44 patients (40%) were hospitalized and treated by recombinant or/and plasma-derived FVIII or FIX or/and rFVIIa. Overall median annual consumption of anti-haemophilic drugs per patient was estimated at 1,333 UI/kg, with a median cost-of-illness of 1,156 euros/kg. Patients with severe haemophilia B consumed more than patients with severe haemophilia A, though not significantly (P = 0.096), with a median of 2,167 vs. 1,100 UI/kg/year and a median cost of 1,760 vs. 917 euros/kg/year (P = 0.13). Children consumed respectively more than adults (P = 0.008), with a median of 3,204 vs. 1,106 UI/kg/year and a median cost of 2,614 vs. 913 euros/kg/year (P = 0.012). The median cost for patients with an inhibitor was 3,291 euros/kg/year, approximately threefold higher than that of patients without an inhibitor (926 euros/kg/year) (P = 0.022). Conclusion It suggests a higher consumption and cost of anti-haemophilic drugs among children when compared to adults. Haemophilia B patients did not consume significantly more than haemophilia A patients, whereas the consumption and cost for patients with or without inhibitors differed significantly.

Keywords

Clotting factors Cost-of-illness France Haemophilia Pharmacoeconomics 

Notes

Acknowledgements

We are indebted to Bayer Laboratory and Biotech Division for logistic and organisational assistance. We also thank Ms Pamela Albert for English assistance in the correction of the manuscript.

Conflicts of interest

There is no potential conflict of interest related to the content of this manuscript.

References

  1. 1.
    Macik BG. Treatment of factor VIII inhibitors: products and strategies. Semin Thromb Haemost 1993;19(1):13–24CrossRefGoogle Scholar
  2. 2.
    DiMichele DM. Inhibitors in haemophilia: a primer. Haemophilia 2000; 6(1):38–40PubMedCrossRefGoogle Scholar
  3. 3.
    Sultan Y. The French Hemophilia Study Group. Prevalence of inhibitors in a population of 3,435 hemophilia patients in France. Thromb Haemost 1992;67:600–2Google Scholar
  4. 4.
    Molho P, Rolland N, Lebrun T, Dirat G, Courpied JP, Croughs T, et al. Epidemiological survey of the orthopaedic status of severe haemophilia A and B patients in France. Haemophilia 2000;6(1):23–32PubMedCrossRefGoogle Scholar
  5. 5.
    Jasso-mosqueda JG, Omnès LF, Gomez E, et al. Description of the management of patients suffering from type A haemophilia [Description de la prise en charge de l’hémophilie sévère de type A par le programme de médicalisation des Systèmes d’information : intérêts et limites]. J Econ Med 2000;18:323–30Google Scholar
  6. 6.
    D’Alche-Gautier MJ, Gautier P, Stieltjes N, et al. Economic study of clotting factor therapy in haemophilia [Coût du traitement substitutif des hémophiles hospitalisés]. J Econ Med 2001;19:157–66Google Scholar
  7. 7.
    Schramm W, Royal S, Kroner B, Berntorp E, Giangrande P, Ludlam C, et al. Clinical outcomes and resource utilization associated with haemophilia care in Europe. Haemophilia 2002;8(1):33–43PubMedCrossRefGoogle Scholar
  8. 8.
    Auerswald G, Von Depka Prondzinski M, Ehlken B, Kreuz W, Kurnik K, Lenk H, et al. Treatment patterns and cost-of-illness of severe haemophilia in patients with inhibitors in Germany. Haemophilia 2004;10:499–508PubMedCrossRefGoogle Scholar
  9. 9.
    Chang H, Sher GG, Blanchette VS, Teitel JM. The impact on the cost of clotting factor replacement therapy in haemophilia A in Canada. Haemophilia 1999;5(4):247–52PubMedCrossRefGoogle Scholar
  10. 10.
    Rivard GE, Vick S. Factor VIII inhibitor treatment. Economics of inhibitor treatment in Canada. Semin Hematol 1994;31(4):41–3PubMedGoogle Scholar
  11. 11.
    Bohn RL, Aledort LM, Putnam KG, Ewenstein BM, Mogun H, Avorn J. The economic impact of factor VIII inhibitors in patients with haemophilia. Haemophilia 2004;10(1):63–8PubMedCrossRefGoogle Scholar
  12. 12.
    Gautier P, D’Alche-Gautier MJ, Coatmelec B, Marques-Verdier A, Bertrand MA, Dieval J, et al. Cost related to replacement therapy during hospitalization in haemophiliacs with or without inhibitors: experience of six French haemophilia centres. Haemophilia 2002;8(5):674–9PubMedCrossRefGoogle Scholar
  13. 13.
    Goudemand J. Hemophilia. Treatment of patients with inhibitors: cost issues. Haemophilia 1999;5(6):397–401PubMedCrossRefGoogle Scholar
  14. 14.
    Ehrenforth S, Kreuz W, Scharrer I, Linde R, Funk M, Güngör T, et al. Incidence of development of factor VIII and factor IX inhibitors in haemophiliacs. Lancet 1992;339:594–8PubMedCrossRefGoogle Scholar
  15. 15.
    Calvez T, Biou M, Costagliola, Jullien AM, Laurian Y, Rossi F, et al. The French haemophilia cohort: rationale and organization of a long-term national pharmacosurveillance system. Haemophilia 2001;7:82–8PubMedCrossRefGoogle Scholar
  16. 16.
    Gill FM. The natural history of factor VIII inhibitors in patients with haemophilia A. Prog Clin Biol Res 1984;150:19–29PubMedGoogle Scholar
  17. 17.
    Shapiro A. Inhibitor treatment: state of the art. Semin Hematol 2001;38:26–34PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2007

Authors and Affiliations

  • Virginie Nerich
    • 1
    • 2
  • Edgar Tissot
    • 1
  • Albert Faradji
    • 3
  • Karine Demesmay
    • 4
  • Marie Anne Bertrand
    • 5
  • Jean-Louis Lorenzini
    • 6
  • Marie-Elisabeth Briquel
    • 7
  • Patricia Pouzol
    • 8
  • Marie-Christine Woronoff-Lemsi
    • 1
    • 2
    Email author
  1. 1.Department of PharmacyUniversity Hospital of BesançonBesanconFrance
  2. 2.INSERM U645 EA-2284 IFR-133BesanconFrance
  3. 3.Haemophilia Treatment Centre “Alsace”University Hospital of StrasbourgStrasbourgFrance
  4. 4.Department of PharmacyUniversity Hospital of StrasbourgStrasbourgFrance
  5. 5.Haemophilia Treatment Centre “Franche-Comté” University Hospital of BesançonBesanconFrance
  6. 6.Haemophilia Treatment Centre “Bourgogne”University Hospital of DijonDijonFrance
  7. 7.Haemophilia Treatment Centre “Lorraine”University Hospital of NancyNancyFrance
  8. 8.Haemophilia Treatment Centre “Champagne-Ardennes”University Hospital of Reims ReimsFrance

Personalised recommendations