Analysis of Direct Costs of Treating Severe Hemophilia A in Brazil

OBJECTIVES: In Brazil, hemophilia treatment centers hold and distribute all clotting factor concentrates nationwide, nonetheless the economic burden of hemophilia A (HA) management in the Public Healthcare System (SUS) needs to be further understood. We aimed to estimate the direct costs related to the treatment of severe HA without inhibitors in SUS.

METHODS: After the development of discussion guides based on literature review, a panel of experts provided opinion towards the healthcare resource use and the costs associated to the HA management between June/22 and June/23. Costs were obtained from publicly available sources used by SUS and were expressed in annual values (Brazilian national currency).

RESULTS: Data from 838 HA patients were analyzed. Adult severe HA patients without inhibitors (≥18 years of age) represented 53% of individuals with HA. The estimated annual cost of HA in this population was R$347,008.69. Coagulation FVIII consumption corresponded to 90% of the cost, with most individuals (83%) using standard half-life recombinant FVIII, (average consumption of 5,658.65 IU/Kg/year, costing R$312,536.52/year). Plasma-derived concentrates were also used (17%; 5,300.10 IU/Kg/year; R$27,309.29). Annual costs related to hospitalization, surgeries, and supplementary treatment were R$264.25, R$717.99, and R$158.44, respectively.

CONCLUSIONS: This study provided estimated cost information for adult severe HA without inhibitors within the Brazilian healthcare system context and suggested that replacement therapy with FVIII is the key driver for the economic burden.