OBJECTIVES:

Though a majority of hemophilia treatment cost comes from factor-replacement therapy, cost savings related to healthcare use may result from optimal prophylactic therapy. We characterized real-life healthcare utilization and costs among Finnish patients with hemophilia A (HA) and hemophilia B (B).

METHODS:

The data on resource use were collected from patient charts generated over a period of four years (2012-2016). Annual healthcare costs were calculated based on resource utilization and Finnish report of standard unit costs.

RESULTS:

A total of 131 HA patients and 39 HB patients were included. Of HA patietns, 56% (n=74) received prophylactic therapy (HAP), and 25% (n=31) received on-demand therapy (HAO). Over 90% of HAP and HAO patients had outpatient visits during follow-up. The mean outpatient visits/year/patient was 2.4 for HAP and 1.9 for HAO. Overall, 43% of HAP patients, and 27% of HAO patients had inpatient stays during follow-up; the mean lenhgt of stay was 11.9 days for HAP, and 15.3 days for HAO. The total annual healthcare cost were 8,530€ for HAP and 12,584 for HAO. Of HB patients, 31% (n=12) received prophylactic therapy (HBP), whereas 54% (n=21) received on-demand therapy (HBO). Over 90% of HBP and HBO had outpatient visits during follow-up. The mean outpatient visits/year/patient was 1.8 for HBP and 2.1 for HBO. Overall, 25% of HBP patients, and 52% of HBO patients had inpatient stays during follow-up; the mean lenhgt of stay was 3.0 days for HBP, and 11.3 days for HBO. The total annual healthcare cost were 1,358€ for HBP and 9,517 for HBO. Except for the results regarding annual healthcare cost between HBP and HBO (p>0.001), statistical significance was not reached.

CONCLUSIONS:

Patients receiving on-demand therapy have higher healthcare costs than patients treated prophylactically. Selecting between prophylaxis and on-demand therapy should be done under careful considearation.