OBJECTIVES: Egypt is currently managing Hemophilia A patients through reactive on-demand control of bleeding episodes imposing a significant economic burden on public payor budgets and deteriorated quality of patients’ life. The main objective of this study was to assess the impact on the public payor budgets when adopting hemophilia treatments prophylactically across pediatric and adult populations compared to an optimum on-demand approach in Egypt.

METHODS: An excel-based analysis was created measuring the direct medical costs from payor perspective when used prophylactically and the consequent economic benefits compared to hypothetical on-demand management approach considering that all eligible patients are utilizing public insurance that treatments are administered based on their SmPC. Hemophilia A population prevalence, age and inhibitors incidence were calculated from figures reported by WFH report 2020. Annual bleeding rate (ABR) on on-demand approach was collected from published studies. ABR on prophylactic approach was obtained from treatment’s published clinical studies.

RESULTS: Egypt has a prevalence of 5,084 hemophilia A patients. Public payor covers 1,373 pediatric patients with average weight of 28.5 KG. and 1,678 adult patients with average weight of 70 KG. With an average ABR of 14 bleeding episodes for pediatrics and adults respectively. Prophylactic approach significantly reduced the ABR to 1.5-7.9 bleeding episodes based on the different approved medications. Comparing prophylactic approach to on-demand approach yielded annual budget reductions in bleeding management, disease related surgery, admission and physiotherapy costs resulting in savings up to 25% compared to the hypothetical on-demand approach. Weighted average savings can reach up to EGP 260k per patient per year across both pediatric and adult with and without inhibitors populations.

CONCLUSIONS: Prophylactic management of Hemophilia A in Egypt would result in a significant budget saving compared to on-demand approach. The results of this model would inform decision makers for efficient resources allocation in Hemophilia care in Egypt.