OBJECTIVES

: Introduction of new treatments is expected to improve the management of patients with hemophilia A (HA). The HEMRAUDE study was conducted to describe profile of patients with HA, disease management, and direct economic burden in a collective perspective.

METHODS

: This retrospective study was conducted using the national French administrative healthcare claims database SNDS which includes ambulatory and hospital care. Male patients affected with HA were included in the study between January 1, 2016 and December 31, 2017. Patients were classified in 6 treatment groups: no treatment, on-demand FVIII, FVIII in the immune tolerance induction (ITI) protocol, FVIII prophylaxis, on-demand bypassing agents, and bypassing agent prophylaxis. Costs of care for HA patients were compared to a control population without coagulation disorder and matched (ratio 1:3) on age and gender.

RESULTS

: A total of 4,172 HA patients (all degree of severity) were included in the analysis, aged on average 35.2 years, 5.3% had HIV infection, and 8.8% had hepatitis B/C. Half of the patients received no treatment for HA, 25% were treated with FVIII on demand and 20.7 % had long-term FVIII prophylaxis. The direct burden per HA patient was estimated at €70,573 per year. The most part of the economic burden (96.3%) was attributable to the drugs used to treat HA. The highest costs were observed in patients treated with FVIII in ITI protocol (€833,763/year) and those receiving bypassing agent prophylaxis (€825,668/year). Based on life expectancy and assuming stable costs in the future, the direct cost of hemophilia care over the lifetime of patients is estimated to be around €4.5 million.

CONCLUSIONS

In real life, assuming that all HA patients have been identified in the study, healthcare costs for HA population in France would amount over €300 million in 2017 (i.e. 0.15% of collective expenditure on healthcare in France).