OBJECTIVES : To estimate the impact on the cost of two years of care for the first Cuban patient with hemophilia A with inhibitors (HAwI) treated with Emicizumab versus two years of previous care with rFVIIa.

METHODS : The 2017 – 2018 period of treatment using rFVIIa on demand was compared to the 2019 – 2020 period using Emicizumab prophylaxis in an adult patient diagnosed with HAwI. In both scenarios, include annual bleeding rate (ABR), hospitalization costs and other medications which were obtained from clinical records. The source of costs is the Cuban National Hemophilia Program. The perspective of the analysis is the Cuban health system that has universal coverage of its population.

RESULTS : During 2017 – 2018 period the total cost of care including rFVIIa, tranexamic acid, transfusions and hospitalization was USD $ 1,780,691 with ABR = 105. During 2019 – 2020 period the total cost of care using prophylaxis with Emicizumab was USD $ 988,182. In this period, there were no hospitalizations or bleeding events, ABR=0.

CONCLUSIONS : In the first Cuban patient in prophylaxis treatment with Emicizumab for Hemophilia A with Inhibitors, biannual savings were generated for the National Hemophilia Program of USD $ 792,509 (44, 6%) versus the previous treatment with rFVIIa on demand. The ABR was reduced to zero bleeding events with Emicizumab, avoiding costs associated with hospitalizations and complications derived from joint bleeding.