OBJECTIVES: In Mexico, it is estimated that 4,761 people live with hemophilia A. If treated with short acting FVIIIr molecules, these patients face the burden of constant infusions which can limit treatment adherence and therefore health outcomes. Weekly application treatment improves adherence which in turns prevents complications and is available in Mexico with emicizumab and damoctocog alfa pegol. The objective of the analysis is to assess the annual cost of treating patients ≥ 12 years with severe hemophilia A without inhibitors with damoctocog alfa pegol vs emicizumab in Mexico.

METHODS: A cost minimization analysis was developed to estimate the annual cost associated with the treatment of patients ≥ 12 years with severe hemophilia A without inhibitors, previously treated, with damoctocog alfa pegol or emicizumab. The model was conducted in MicrosoftExcel®2013.

The analysis was conducted under the public payer´s perspective, hence only direct medical costs were considered.

The dose for emicizumab was estimated using the as per label dose; while a weighted average was used to estimate the dose for damoctocog alfa pegol, considering the proportion of patients in each dose used in PROTECT VIII clinical trial.

Drug prices were gathered from Mexican official sources as of April 2023.

No discount rate was applied as the temporal horizon of the analysis was 1 year.

RESULTS: The annual cost of treating patients ≥ 12 years with severe hemophilia A without inhibitors with damoctocog alfa pegol was $3,146,998 MXN. The annual cost of using emicizumab was $5,527,200 MXN. Thus, the analysis suggests that using damoctocog alfa pegol would represent savings up to 43% of the annual cost of using emicizumab.

CONCLUSIONS: From the perspective of the Mexican public payer, the results suggests that damoctocog alfa pegol is a cost saving alternative vs emicizumab in the treatment of patients ≥ 12 years with severe hemophilia A without inhibitors: