THE HEALTH CARE RESOURCE UTILIZATION (HCRU) AND CLINICAL BURDEN OF HEMOLYTIC DISEASE OF THE FETUS AND NEWBORN (HDFN) IN EUROPE - FINDINGS FROM A REAL-WORLD SURVEY
Author(s)
Jennifer Norma Barthelmes, MSc1, Umber Agarwal, Dr.2, Gonçalo Rodrigues, PHD3, Gregor Gibson, Bsc.4, Alisha Braid, Bsc.4, Wim Noel, PhD5, Tom Denee, MBA, PharmD6.
1Johnson & Johnson, Neuss, Germany, 2Liverpool Women’s Hospital, Liverpool, United Kingdom, 3Johnson & Johnson, Madrid, Spain, 4Adelphi Real World, Bollington, United Kingdom, 5Johnson & Johnson, Zemst, Belgium, 6Johnson & Johnson, Breda, Netherlands.
1Johnson & Johnson, Neuss, Germany, 2Liverpool Women’s Hospital, Liverpool, United Kingdom, 3Johnson & Johnson, Madrid, Spain, 4Adelphi Real World, Bollington, United Kingdom, 5Johnson & Johnson, Zemst, Belgium, 6Johnson & Johnson, Breda, Netherlands.
OBJECTIVES: HDFN is a rare severe alloimmune condition. This research aims to assess time to diagnosis, clinical burden and HCRU, in the real-world management of HDFN across Europe.
METHODS: Data were drawn from a multinational survey. Specialists in maternal-fetal medicine and neonatal-perinatal care from France, Germany, Italy, Spain, and the United Kingdom completed structured case record forms for recent moderate/severe HDFN affected pregnancies encountered in routine clinical practice. Analyses were descriptive.
RESULTS: Among all pregnancies (n=193), first healthcare consultation occurred at mean gestational age of 11.6 weeks, while diagnosis emerged at 26.1 weeks. In women with prior HDFN (19%), diagnosis occurred earlier at 23.9 weeks. Prenatal intervention was required in 43% of pregnancies, and in 58% of pregnancies with prior HDFN, most commonly intrauterine transfusions and prenatal intravenous-immunoglobulin (IVIg). Unexpected maternal hospitalizations occurred in 54%/53% of overall pregnancies/pregnancies with prior HDFN /most were directly attributable to HDFN; 49% were emergency admissions and 13% intensive care. Among pregnancies requiring inpatient care), mean length of stay for the first hospitalization was 4.8 nights, and 7.7 nights for pregnancies with prior HDFN. Among successful deliveries (n=137), mean gestational age was 34.6 weeks. Neonatal intervention was required in 66% pregnancies, and in 89% pregnancies with prior HDFN including phototherapy red blood cell transfusion, exchange transfusion, and IVIg. Mean postnatal hospital stay was 11.4 days /13.8 days, with 26% lasting ≥7 days and hospital readmission within 12 months requiring neonatal intensive care was reported in 44/%/33% of infants following pregnancy with/without prior HDFN respectively. Among cases with neonatal survival 43% of mothers were reported as anxious and depressed.
CONCLUSIONS: These findings highlight the potential value of earlier diagnosis, early referral, more effective therapies and improved access to specialist maternal fetal medicine specialists to optimize outcomes for these high-risk pregnancies.
METHODS: Data were drawn from a multinational survey. Specialists in maternal-fetal medicine and neonatal-perinatal care from France, Germany, Italy, Spain, and the United Kingdom completed structured case record forms for recent moderate/severe HDFN affected pregnancies encountered in routine clinical practice. Analyses were descriptive.
RESULTS: Among all pregnancies (n=193), first healthcare consultation occurred at mean gestational age of 11.6 weeks, while diagnosis emerged at 26.1 weeks. In women with prior HDFN (19%), diagnosis occurred earlier at 23.9 weeks. Prenatal intervention was required in 43% of pregnancies, and in 58% of pregnancies with prior HDFN, most commonly intrauterine transfusions and prenatal intravenous-immunoglobulin (IVIg). Unexpected maternal hospitalizations occurred in 54%/53% of overall pregnancies/pregnancies with prior HDFN /most were directly attributable to HDFN; 49% were emergency admissions and 13% intensive care. Among pregnancies requiring inpatient care), mean length of stay for the first hospitalization was 4.8 nights, and 7.7 nights for pregnancies with prior HDFN. Among successful deliveries (n=137), mean gestational age was 34.6 weeks. Neonatal intervention was required in 66% pregnancies, and in 89% pregnancies with prior HDFN including phototherapy red blood cell transfusion, exchange transfusion, and IVIg. Mean postnatal hospital stay was 11.4 days /13.8 days, with 26% lasting ≥7 days and hospital readmission within 12 months requiring neonatal intensive care was reported in 44/%/33% of infants following pregnancy with/without prior HDFN respectively. Among cases with neonatal survival 43% of mothers were reported as anxious and depressed.
CONCLUSIONS: These findings highlight the potential value of earlier diagnosis, early referral, more effective therapies and improved access to specialist maternal fetal medicine specialists to optimize outcomes for these high-risk pregnancies.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE111
Topic
Clinical Outcomes, 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)