OBJECTIVES: A US Real-World study found the median recombinant coagulation factor VIII (rFVIII) international units (IUs) dispensed were between 10% and 45% higher with extended half-life (EHL) versus standard half-life (SHL) products. The objective was to evaluate the cost of SHL versus EHL rFVIII in Spain.

METHODS: A probabilistic model (second order Monte Carlo simulation) in a hypothetical cohort of 1,000 patients with hemophilia A and a time horizon of 1 year was carried out. The mean IUs dispensed quarterly with each rFVIII were taken from a Real-World study, conducted in two US databases, which included 776 patients with hemophilia A. The frequency of use of each recombinant rFVIII was obtained from sales estimation (IMS) of a 12-months period in Spain (BOE, 2018). rFVIII prices (€ 2019) were obtained from the Reference Price Order by the National Health System. A base case analysis, considering the use of rFVIII in the clinical practice in Spain and two sensitivity analyzes were performed.

RESULTS: In the base case analysis, an average annual saving per patient treated with SHL of € 11,227 was obtained, with a 75.5% saving probability. The results were stable for sensitivity analyzes performed. In the event that there was no change in treatment from the SHL to the EHL, there would be a greater annual saving per patient (€ 53,078) with a 99.9% saving probability. When applying the rFVIII frequency of use in the clinical practice in the US, the annual savings per patient treated with SHL instead of EHL would amount to € 16,350, with a saving probability of 79.9%.

CONCLUSIONS: The probabilistic model found higher expenditures over one year for hemophilia A patients using EHL versus SHL products. The use of SHL instead of EHL, would amount to cost savings to the National Health System in Spain.