ASSOCIATIONS BETWEEN INHIBITORS, TREATMENT REGIMEN, AND BLEED FREQUENCY AND HEALTHCARE PRACTITIONER UTILISATION IN THE HAEMOPHILIA TREATMENT CENTRE (HTC)- GLOBAL RESULTS FROM THE HAEMOPHILIA EXPERIENCES, RESULTS AND OPPORTUNITIES (HERO) STU ...
Author(s)
Nugent D1;Stain AM2;Gregory M3;Pericleous L4;Cooper DL*5, Iorio A6 1Hematology and Children's Hospital of Orange County Blood and Donor Center, Orange, CA, USA, 2Kiddies Health Care Inc., Toronto, ON, Canada, 3UK Haemophilia Society, London, England, 4Novo Nordisk A/S, Søborg, Denmark, 5Novo Nordisk, Inc., Princeton, NJ, USA, 6McMaster University, Hamilton, ON, Canada
OBJECTIVES: To describe the relationship between resource utilisation, inhibitor status, treatment regimen and bleed frequency in the HERO Study. METHODS: A post-hoc descriptive analysis of adult people with haemophilia (PWH) and children with haemophilia (CWH) aged <18 years, with (WI) and without inhibitors (WOI), from 8 countries with home treatment (AR/CN/DE/FR/IT/SP/UK/US) are presented. RESULTS: Most PWH (431 WOI, 84 WI) and CWH (411 WOI, 42 WI) were without inhibitors. Use of on-demand and prophylaxis treatment was evenly distributed among PWH (180 on-demand, 203 prophylaxis); most CWH were on prophylaxis (87 on-demand, 335 prophylaxis). Mean/median bleeds per year were higher in PWH WOI on prophylaxis (14.9/5) than on-demand (10.3/2), but lower in WI on prophylaxis (5.6/2) than on-demand (15.6/7). Higher-risk activities were reported more for PWH on prophylaxis (15% vs. 8%) and with decreasing annual bleed rates (15%-9%). Mean/median annual bleeds were higher in CWH WOI on on-demand (7.5/3) than prophylaxis (5.2/3) and in WI on prophylaxis (12.1/8) than on-demand (9.2/6). Mean annual haemophilia treatment centre (HTC) visits were slightly higher on prophylaxis for PWH (prophylaxis 4.5, on-demand 3.7) and CWH (prophylaxis 5.6, on-demand 4.8). For CWH, median HTC visits increased with increasing bleed frequency (2-5/year). Nurse involvement in haemophilia management was more frequently reported by PWH on prophylaxis (57%) than on-demand (45%). Nurse (37%-57%), social worker (9%-32%), and physiotherapist (20%-37%) involvement increased with bleed frequency in PWH. CWH WI reported more nurse involvement on prophylaxis (71%) than on-demand (57%) but less social worker involvement (8% vs. 29%); physiotherapists were more frequently involved for CWH WOI on prophylaxis (34%, on-demand 23%). CONCLUSIONS: HTC utilisation was higher for PWH/CWH on prophylaxis; for CWH, bleed frequency increased utilisation. Involvement of physiotherapy and social work was less than expected for PWH/CWH, but could positively impact bleed rate; and, overall utilization deserves further study.
Conference/Value in Health Info
2013-05, ISPOR 2013, New Orleans, LA, USA
Value in Health, Vol. 16, No. 3 (May 2013)
Code
PSY86
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Systemic Disorders/Conditions