OBJECTIVES : To compare the annual cost of prophylaxis treatment with a bypass agent for a pediatric patient with Severe Hemophilia A and Inhibitors versus annual cost of prophylaxis treatment with a monoclonal antibody.

METHODS : The direct comparison of drug costs was made by comparing a one-year prophylactic treatment with aPCC bypass agent in a 28 kg pediatric patient with Severe Hemophilia A and Inhibitors with a treatment scheme of 35 IU / kg intravenously 3 times per week versus the estimated cost of one-year prophylactic treatment with Emicizumab (bispecific monoclonal antibody) with a loading dose of 3 mg / kg every week for the first 4 weeks and a maintenance dose of 3 mg / kg weight every two weeks subcutaneously according to medical criteria and indication of product approval in Peru.

RESULTS : The cost of a one-year prophylactic treatment with aPCC for a pediatric patient in Peru was $273.772 USD. The estimated cost of one-year prophylactic treatment with Emicizumab for a pediatric patient with HAI was $ 119,496 USD.

CONCLUSIONS : Emicizumab generates an annual saving of 56% $ 154,276 USD in direct comparison of medications costs regarding the use of aPCC for prophylaxis of a pediatric patient with Severe Hemophilia A and inhibitors from Peru. For the present analysis, the maintenance dose of Emicizumab was used every 2 weeks, emicizumab could be used with weekly subcutaneous application, every 2 weeks or every 4 weeks, preserving the cost savings compared to bypass agent in the annual comparison.