OBJECTIVES : To estimate the impact on the annual cost of care of the first Cuban patient with hemophilia A and inhibitors (HAI) treated with emicizumab.

METHODS : Annual cost of medications and hospitalization costs associated with the number of bleeding episodes are compared using one year of on-demand rFVIIa versus annual cost of prophylaxis with Emicizumab in an adult patient diagnosed with Hemophilia A and Inhibitors.

Before initiating emicizumab prophylaxis, the patient received on-demand treatment with rFVIIa. The cost and dose for care of each bleeding event treated with rFVIIa was obtained from the records of care of the National Hemophilia Program of Cuba and compared with the annual cost of prophylaxis with Emicizumab for one year with a loading dose of 3 mg / kg weekly subcutaneous for one month and 1.5 mg / kg weekly subcutaneous from the fifth week as maintenance dose.

RESULTS : During the year of rFVIIa use on demand, 105 bleeding episodes (Annual Bleed Rate ABR = 105) and 15 days of hospitalization were recorded. The annual cost of rFVIIa on demand used was 560,000 USD and the cost of hospitalization was 11,550 USD. In the year of use of Emicizumab, the patient did not present any bleeding episode (ABR = 0) or hospitalizations. It did not require the use of rFVIIa or another factor, the cost of the year of care in prophylaxis with Emicizumab was 413,896 USD. The patient improved his joint mobility and return to work and productivity after using emicizumab.

CONCLUSIONS : The use of emicizumab in an adult patient diagnosed with Hemophilia A and inhibitors in Cuba generated total annual savings of $ 157,654 (27.5%) versus treatment from the previous year with rFVIIa on demand. Reducing the annual bleeding rate (ABR) from 105 using rFVIIa to 0 bleeds with Emicizumab avoided costs associated with hospitalizations.