Presentation (CTI)

OBJECTIVES: Hemophilia A is a chronic disorder characterized by severe bleeding complications that significantly burden patients’ care pathways. Emicizumab, a prophylactic treatment introduced in France in 2018 and dispensed in community pharmacies since 2021, has demonstrated positive clinical and societal impacts by reducing bleeding episodes, the use of hospital resources, and associated costs. Building on a previous model estimating societal and economic impact, this study assesses the environmental impact of emicizumab by quantifying carbon emissions across dual distribution and dispensing pathways for hemophilia care.
METHODS: The analysis followed the Shift Project framework, combining bottom-up and top-down approaches to estimate carbon emissions, including those related to hospitalizations, the transport required for hemostatic treatments dispensing, and the treatment-specific carbon footprint. Data were derived from the Shift Project and complemented with other sources including the French Agency for Ecological Transition. Total emissions were compared between scenarios with and without emicizumab across two-time horizons: 2018-2025 (carbon balance sheet) and 2026-2030 (carbon emissions projections).
RESULTS: Between 2018 and 2025, emicizumab introduction in a cohort of 2,270 patients reduced the carbon footprint of the hemophilia A care pathway by 38%, corresponding to 3,843 tCO2e, equivalent to over 91,000 hospitalization days or 400,000 patient transports. The largest reductions were estimated in transport for treatments dispensing (-30%) and treatment-specific carbon footprint (-50%). At patient level, this reduction amounted to 1.7 tCO2e. Projections from 2026 to 2030 estimate a further 68% reduction, with annual per-patient emissions decreasing by 423 kgCO2e.
CONCLUSIONS: Beyond societal benefits already observed in the literature, emicizumab has substantially lowered the environmental footprint associated with France’s dual distribution and dispensing for hemophilia pathways, driven by reduced treatment-related emissions. These findings highlight the importance of incorporating environmental metrics into healthcare policy and demonstrate how innovative therapies can optimize clinical, societal and environmental dimensions of care pathways.