López-Facundo A, Rodríguez-Castillejos C, Romero Y, Gay J, Prada D

Language: Spanish
References: 14
Page: 369-376
PDF size: 150.35 Kb.

ABSTRACT

Introduction: Few studies have assessed the economic impact of inhibitors in hemophilia A in Mexico, especially in the pediatric population. Objective: To determine the economic impact entailed by the development of inhibitors in pediatric patients with hemophilia A. Method: Patients with hemophilia A under the care of a pediatric hematology department between December 2015 and November 2017 were retrospectively assessed. Direct and indirect costs were determined based on the presence or absence of inhibitors. Results: The cost analysis of the study population (n = 24) showed that diagnosis, follow-up, prophylaxis, treatment and hospitalization of these patients had an annual cost of $ 6 883 187.4 per patient, out of which more than 95 % depended on the use of hemostatic factors. Annual cost per patient in the group with inhibitors was $ 5 548 765.0 in comparison with $ 1 334 422.4 in the group without inhibitors, 4.2 times higher. Conclusions: This is the first national study to show that the presence of inhibitors in pediatric patients with hemophilia A increases the cost of the disease more than four times.

REFERENCES

1. Gringeri A, Lundin B, von Mackensen S, Mantovani L, Mannucci PM, ESPRIT Study Group. A randomized clinical trial of prophylaxis in children with hemophilia A (the ESPRIT Study). J Thromb Haemost. 2011;9:700-710.

2. Qu Y, Nie X, Yang Z, Yin H, Pang Y, Dong P, et al. The prevalence of hemophilia in mainland China: a systematic review and meta-analysis. Southeast Asian J Trop Med Public Health. 2014;45:455-466.

3. Valentino LA, Hakobyan N, Enockson C, Simpson ML, Kakodkar NC, Cong L, et al. Exploring the biological basis of haemophilic joint disease: experimental studies. Haemophilia. 2012;18:310-318.

4. Ljung R, Gretenkort-Andersson N. The current status of prophylactic replacement therapy in children and adults with haemophilia. Br J Haematol. 2015;169:777-786.

5. Rocino A, Cortesi PA, Scalone L, Mantovani LG, Crea R, Gringeri A, et al. Immune tolerance induction in patients with haemophilia a and inhibitors: effectiveness and cost analysis in an European Cohort (The ITER Study). Haemophilia. 2016;22:96-102.

6. Carlos-Rivera F, Gasca-Pineda R, Majluf-Cruz A, García-Chávez J. Economic impact of hemophilia type A and B in Mexico. Gac Med Mex. 2016;152:19-29.

7. Zhou ZY, Koerper MA, Johnson KA, Riske B, Baker JR, Ullman M, et al. Burden of illness: direct and indirect costs among persons with hemophilia A in the United States. J Med Econ. 2015;18:457-65.

8. Shrestha A, Eldar-Lissai A, Hou N, Lakdawalla DN, Batt K. Real-world resource use and costs of haemophilia A-related bleeding. Haemophilia. 2017;23(4) e267-e275.

9. Castillón-Benavides NK. Impacto económico del tratamiento de pacientes pediátricos con hemofilia tipo A en el Hospital Materno Infantil de ISSEMyM [tesis de posgrado]. México: Universidad Autónoma del Estado de México; 2016.

10. Gringeri A, Mantovani LG, Scalone L, Mannucci PM, COCIS Study Group. Cost of care and quality of life for patients with hemophilia complicated by inhibitors: the COCIS Study Group. Blood. 2003;102:2358-2363.

11. Srivastava A, Brewer AK, Mauser-Bunschoten EP, Key NS, Kitchen S, Llinas A, et al. Guidelines for the management of hemophilia. Haemophilia. 2013;19 e1-e47.

12. Secretaría de Salud. Guía de práctica clínica. Diagnóstico y tratamiento de hemofilia en adultos. México: Secretaría de Salud; 2010.

13. Fernandes S, Carvalho M, Lopes M, Araújo F. Impact of an individualized prophylaxis approach on young adults with severe hemophilia. Semin Thromb Hemost. 2014;40:785-789.

14. Balkaransingh P, Young G. Novel therapies and current clinical progress in hemophilia A. Ther Adv Hematol. 2018;9:49-61.