Economic Impact of Emicizumab vs. On-Demand Therapy With Bypassing Agents in Patients With Hemophilia A With Inhibitors in Mexico
Author(s)
Luis A. Domínguez Ventura, Hematologist1, Jaime García Chávez, Hematologist2.
1Instituto Mexicano del Seguro Social, Ciudad de México, Mexico, 2Instituto Mexicano del Seguro Social, Ciudad de Mexico, Mexico.
1Instituto Mexicano del Seguro Social, Ciudad de México, Mexico, 2Instituto Mexicano del Seguro Social, Ciudad de Mexico, Mexico.
OBJECTIVES: Hemophilia A with inhibitors (HA-wI) substantially increases medical costs, which represents a financial challenge for publicly funded health systems. The objective of this study is to quantify the economic benefit of emicizumab in patients with HA-wI compared to on-demand therapy with bypassing agents at a third-level hospital of the Mexican Institute of Social Security (IMSS) in Mexico City.
METHODS: Comparative, descriptive and single-center study in patients ≥18 yo diagnosed with severe HA-wI. A database for healthcare costs (including hemostatic factors) was designed based on institutional cost tabulator. Costs were measured at two time points: during on-demand treatment and during emicizumab prophylaxis in the same patients at two-year follow-up for each arm. For each variable, the means and standard deviations were calculated per group. The heterogeneity of variances between the groups for both variables was assessed using F-tests, and when (p<0.001 for both) was identified, the two-tailed Welch t-test (α=0.05) was used to compare the means between the treatments.
RESULTS: The analysis revealed that patients with on-demand therapy incurred in substantially higher costs of care ($9,247.49 USD) compared to those who used emicizumab ($773.27 USD; p<0.001). Likewise, a marked difference in expenditure on hemostatic factors was found, with a significantly higher average in the on-demand therapy group ($222,624.75 USD) in contrast to the emicizumab group ($4,533.66 USD; p<0.001). There was also a 99% reduction in medical care associated with spontaneous hemorrhages, resulting in a reduction in hospitalizations and the use of hospital services such as laboratory, radiology and surgical interventions during the emicizumab phophylaxis.
CONCLUSIONS: Emicizumab represents a milestone in the current treatment of HA-wI, its impact has shown a new perspective of hope and empowerment in the management of the disease, significantly reducing the expenditure of medical resources associated from bleeding and it´s complications.
METHODS: Comparative, descriptive and single-center study in patients ≥18 yo diagnosed with severe HA-wI. A database for healthcare costs (including hemostatic factors) was designed based on institutional cost tabulator. Costs were measured at two time points: during on-demand treatment and during emicizumab prophylaxis in the same patients at two-year follow-up for each arm. For each variable, the means and standard deviations were calculated per group. The heterogeneity of variances between the groups for both variables was assessed using F-tests, and when (p<0.001 for both) was identified, the two-tailed Welch t-test (α=0.05) was used to compare the means between the treatments.
RESULTS: The analysis revealed that patients with on-demand therapy incurred in substantially higher costs of care ($9,247.49 USD) compared to those who used emicizumab ($773.27 USD; p<0.001). Likewise, a marked difference in expenditure on hemostatic factors was found, with a significantly higher average in the on-demand therapy group ($222,624.75 USD) in contrast to the emicizumab group ($4,533.66 USD; p<0.001). There was also a 99% reduction in medical care associated with spontaneous hemorrhages, resulting in a reduction in hospitalizations and the use of hospital services such as laboratory, radiology and surgical interventions during the emicizumab phophylaxis.
CONCLUSIONS: Emicizumab represents a milestone in the current treatment of HA-wI, its impact has shown a new perspective of hope and empowerment in the management of the disease, significantly reducing the expenditure of medical resources associated from bleeding and it´s complications.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE397
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Rare & Orphan Diseases, Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)