OBJECTIVES: Emicizumab has been approved since 2018 as a prophylactic treatment, administered weekly, for severe haemophilia A (HA), a hereditary bleeding disorder where the blood cannot clot properly leading to prolonged and spontaneous bleeding that can be associated with life-altering complications such as long-term joint problems or intracerebral haemorrhage. Historically, HA treatment in France were available in hospital pharmacies (HP) only requiring patients to visit the hospital regularly to get their treatment supply. However, since 2021, emicizumab is also available in community pharmacies (CP) alleviating the burden for patients and their families of regular hospital visits. The objective of this study was to assess the budget impact of this new delivery option for patients.

METHODS: A budget impact model was built to estimates the time and costs associated with one year HP or CP delivery of emicizumab in the patients’ perspective. Costs included transportation costs to and from the HP or CP considering average distances and transportation modes, as well as wage lost because of time spent in transport and waiting for drug delivery. Two scenarios were compared, including all 1,000 HA patients currently receiving emicizumab in France: before and after CP availability, assuming 50% of patients are choosing CP in 2022.

RESULTS: Per year, patients spent an estimated average of 41.6 hours getting emicizumab from HP compared to 1.7 hours for CP or 39.9 [31.7-49.4] hours saved. HP deliveries were associated with an annual cost for patients of €323 compared to €19 for CP or €304 [224-406] saved. Total annual cost of getting emicizumab before CP availability were €323,000 compared to €171,000 after or €151,700 [96,700 – 220,700] saved by HA patients.

CONCLUSIONS: Emicizumab availability in community pharmacy has substantially reduce the burden of getting treatment for HA patients in France, possibly liberating time and money for non-disease-related activities.