OBJECTIVES

To estimate the indirect transport costs (out-of-pocket expenses) and loss of productivity of caregivers in pediatric patients and loss of productivity of adult patients in prophylaxis for hemophilia A with inhibitors in Colombia.

METHODS

Based on the report of patients with hemophilia A with inhibitors in prophylaxis of High Cost Account 2018, the indirect costs associated with transport and loss of productivity are simulated with respect to the frequencies of treatment of bypass agents (3 times a week) vs emicizumab (once a week with subcutaneous application).

Transportation costs are modeled from the cost of public transport and lost productivity through labor hour costs to estimate in per capita GDP units the impact of bypass agents vs emicizumab.

RESULTS

The annual transportation costs associated with the application of the medication in 93 patients at home are USD 306,100. For an institutional patient, a weekly application has transport costs of USD 154 (60% minimum legal wages) and the patient with three weekly applications costs USD 461 (181% minimum legal wages).

In the 93 patients with application at home, the weekly application with emicizumab generates the annual loss of 0.28 GDP per capita vs. 3.31 GDP per capita with the application of bypass agents.

In the 53 institutional patients, the weekly application with emicizumab generates the annual loss of 1.4 GDP per capita vs 17.4 GDP per capita with the application of bypass agents.

CONCLUSIONS

Reducing the application of prophylaxis in hemophilia A with inhibitors to a weekly frequency improves productivity and decreases the out-of-pocket expenses of patients and caregivers. The use of Emicizumab prevents the loss of 16 GDP per capita in Colombian patients only associated with the frequencies and times of application.