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Guan T, Ai D, Zhao N, Liu G, Yao W, Chen Z, Li Z, Zhou Y, Wu R. Treatment-related outcome from patient report outcome (PRO) of children with severe and moderate hemophilia A in China: An analysis report of registration data from patient organization "hemophilia home care center". Haemophilia 2023; 29:1467-1474. [PMID: 37718575 DOI: 10.1111/hae.14863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 08/31/2023] [Accepted: 09/01/2023] [Indexed: 09/19/2023]
Abstract
OBJECTIVES To assess current treatment-related outcomes for children with severe and moderate haemophilia A (cHA) in China. METHODS This cross-section Patient Report Outcome (PRO) report collected PRO data of severe and moderate cHAs registered in the 'Hemophilia Home Care Center' database (http://web.bjxueyou.cn) between January 2021 and November 2022. Data included records of bleeding, activities, and concentrates consumption. All patients had a confirmed diagnosis of moderate or severe haemophilia A (FVIII: C ≤ 5%) and were < 18 years old. RESULTS Among 1038 analysable cases, 9.6% of children with inhibitors had a higher rate of intracranial haemorrhage, dropout school rate, and higher FVIII consumption than children without inhibitors. Among 100 children with inhibitors, 36 patients were treated without immune tolerance induction (ITI), 14 patients with irregular treatment and 50 patients received ITI. Children with ITI had a lower ABR (2.4 (0,6.6) vs. 13.4 (9.5, 26.6), p<.001) and AJBR (0 (0, 3.1) vs. 8.9 (1.6, 19.3), p < .001) compared to those without ITI. Among 938 children without inhibitors, 28.5% received on-demand treatment and 71.5% received prophylaxis. Of 528 children with 1343.8 (1050.4, 2922.9)IU/kg/year median FVIII consumption, 43.0% received low-dose, 43.2% received intermediate-dose, and 13.8% received high-dose regimen; these children with prophylaxis had a lower ABR (3.1 (0, 10.7) vs. 12.8 (2.4, 45.5), p < .001), AJBR (0.5 (0, 3.9) vs. 3.0 (0, 12.0), p < .001) and disability rate (9.0% vs.18.5%, p = .032) compared to children who received on-demand treatment. CONCLUSION The high rate of drop-out of school and disability still present a huge gap to meet the needs in China. It is necessary to improve the level of medical accessibility and medicine affordability and strengthen the patient/parent's education in China.
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Affiliation(s)
- Tao Guan
- Beijing Hemophilia Home Care Centre, Beijing, China
| | - Di Ai
- Hematology Centre, Beijing Key Laboratory of Paediatric Haematology Oncology, National Key Discipline of Paediatrics, Capital Medical University; Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing Childrenationrsity;, Capital Medical University, National Centre for Childrenal Univer, Beijing, China
| | - Nan Zhao
- Beijing Hemophilia Home Care Centre, Beijing, China
| | - Guoqing Liu
- Hematology Centre, Beijing Key Laboratory of Paediatric Haematology Oncology, National Key Discipline of Paediatrics, Capital Medical University; Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing Childrenationrsity;, Capital Medical University, National Centre for Childrenal Univer, Beijing, China
| | - Wanru Yao
- Hematology Centre, Beijing Key Laboratory of Paediatric Haematology Oncology, National Key Discipline of Paediatrics, Capital Medical University; Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing Childrenationrsity;, Capital Medical University, National Centre for Childrenal Univer, Beijing, China
| | - Zhenping Chen
- Hematologic Disease Laboratory, Beijing Paediatric Research Institute, Beijing Childrenute Laborat, Capital Medical University, National Centre for Childrenal Univer, Beijing, China
| | - Zhenping Li
- Hematology Centre, Beijing Key Laboratory of Paediatric Haematology Oncology, National Key Discipline of Paediatrics, Capital Medical University; Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing Childrenationrsity;, Capital Medical University, National Centre for Childrenal Univer, Beijing, China
| | - Yaohan Zhou
- Hematology Centre, Beijing Key Laboratory of Paediatric Haematology Oncology, National Key Discipline of Paediatrics, Capital Medical University; Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing Childrenationrsity;, Capital Medical University, National Centre for Childrenal Univer, Beijing, China
| | - Runhui Wu
- Hematology Centre, Beijing Key Laboratory of Paediatric Haematology Oncology, National Key Discipline of Paediatrics, Capital Medical University; Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing Childrenationrsity;, Capital Medical University, National Centre for Childrenal Univer, Beijing, China
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Ventola H, Vesikansa A, Jokelainen J, Siitonen T, Ettala P, Laine O, Lehtinen E, Lepäntalo A, Patronen M, Partanen A, Linna M, Ylisaukko-Oja T, Lassila R. Characterisation of healthcare utilisation and cost of haemophilia care in real-life: A 4-year follow-up study in Finland. Haemophilia 2020; 27:e30-e39. [PMID: 33216410 DOI: 10.1111/hae.14197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 10/04/2020] [Accepted: 10/26/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Characterisation of outcomes and costs of haemophilia care in common practice settings is essential for evaluation of new treatment options and for developing clinical practices. In Finland, haemophilia care is mostly centralised to University Hospitals, but treatment practices and costs in adult patients have not been systematically evaluated. AIM This study was designed to characterise healthcare resource utilisation and treatment costs of adult inhibitor-negative haemophilia patients managed in Finnish University Hospitals. METHODS The study was based on a nationwide cohort, which consists of all adult haemophilia A (HA; n = 120) and B (HB; n = 35) patients treated in University Hospitals from 2012 to 2016. Patient characteristics and data on healthcare utilisation and factor replacement use were collected from medical records. Direct costs of care were evaluated based on wholesale drug prices and healthcare service utilisation with standard unit costs. RESULTS Most of HA (79%, n = 96) and HB (84%, n = 31) patients received factor replacement therapy. The median annual bleeding rate (ABR) was low, at 0.8 for HA and 0.5 for HB, also among the patients with on-demand therapy. Over 94% (n = 149) of the patients had outpatient visits during the follow-up period. The mean total annual costs of treatment ranged from €2520 to €176,330. The highest individual cost was factor replacement therapy. CONCLUSION The outcomes of centralising the management of care to University Hospital Treatment Centres show low ABR and lower treatment costs compared with earlier reports from other high-income European populations. Management strategies, including choosing the right therapy between prophylaxis and on-demand, has been successful in Finland.
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Affiliation(s)
- Hanna Ventola
- MedEngine Oy, Helsinki, Finland.,Pfizer Oy, Helsinki, Finland
| | | | - Jari Jokelainen
- MedEngine Oy, Helsinki, Finland.,Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Timo Siitonen
- Department of Medicine, Oulu University Hospital, Oulu, Finland
| | - Pia Ettala
- Division of Medicine, Department of Hematology and Stem Cell Transplantation, Turku University Hospital, Turku, Finland
| | - Outi Laine
- Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
| | - Elina Lehtinen
- Coagulation Disorders Unit, Department of Haematology, Comprehensive Cancer Centre, Helsinki University and Helsinki University Hospital, Helsinki, Finland
| | - Aino Lepäntalo
- Coagulation Disorders Unit, Department of Haematology, Comprehensive Cancer Centre, Helsinki University and Helsinki University Hospital, Helsinki, Finland.,Research Program Unit in Systems Oncology, Faculty of Medicine, Helsinki University, Helsinki, Finland
| | - Maria Patronen
- Coagulation Disorders Unit, Department of Haematology, Comprehensive Cancer Centre, Helsinki University and Helsinki University Hospital, Helsinki, Finland
| | - Anu Partanen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Miika Linna
- Engineering, Management and Architecture (HEMA, Aalto University/Health Care, Espoo, Finland
| | - Tero Ylisaukko-Oja
- MedEngine Oy, Helsinki, Finland.,Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Riitta Lassila
- Coagulation Disorders Unit, Department of Haematology, Comprehensive Cancer Centre, Helsinki University and Helsinki University Hospital, Helsinki, Finland.,Research Program Unit in Systems Oncology, Faculty of Medicine, Helsinki University, Helsinki, Finland
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Kim HK, Peral C, Rubio-Rodríguez D, Rubio-Terrés C. Cost of patients with hemophilia A treated with standard half-life or extended half-life FVIII in Spain. Expert Rev Pharmacoecon Outcomes Res 2020; 21:315-320. [PMID: 32597317 DOI: 10.1080/14737167.2020.1789457] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND In a real-world analysis (RWA) conducted in the United States (US), median international units (IUs) of extended half-life (EHL) recombinant coagulation factor VIII (rFVIII) dispensed were 10% to 45% greater than standard half-life (SHL) rFVIII. The mean IUs of each rFVIII dispensed quarterly were obtained from two databases (N = 776). METHODS A probabilistic model in a 1-year time horizon was used in order to analyze the cost comparison of SHL and EHL rFVIII products in Spain. In this analysis, mean IUs were those of the RWA, and frequency of use and prices for each rFVIII were obtained from sales estimates based on Spanish sources (IQVIA; €, 2019). RESULTS Data showed an average annual savings per patient of €11,227 for SHL rFVIII versus EHL rFVIII products, with a savings probability of 75.5%. The results were stable in the sensitivity analyses. Not switching treatment from SHL to EHL rFVIII resulted in greater savings per patient (€53,078), with a savings probability of 99.9%. Considering the frequency of rFVIII dispensation in the US, annual savings per patient would increase to €16,350 in Spain, with a savings probability of 79.9%. CONCLUSIONS According to this model, use of SHL rFVIII versus EHL rFVIII products could lead to savings for the Spanish National Health System.
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Affiliation(s)
| | - Carmen Peral
- Pfizer, S.L.U., Health Economics & Outcomes Research Department, Madrid, Spain
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Liu Y, Chen L, Li K, Shi M, Poon M. Severe haemophilia A children on low‐dose tertiary prophylaxis showed less joint deterioration and better maintenance of functional independence than children on on‐demand treatment: A 6‐year follow‐up study. Haemophilia 2020; 26:779-785. [PMID: 32700412 DOI: 10.1111/hae.14016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 04/03/2020] [Accepted: 04/08/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Ying Liu
- Department of Physical Medicine and Rehabilitation Peking Union Medical College Hospital Chinese Academy of Medical Science Beijing China
| | - Lixia Chen
- Department of Physical Medicine and Rehabilitation Peking Union Medical College Hospital Chinese Academy of Medical Science Beijing China
| | - Kuixing Li
- Department of Hematology Peking Union Medical College Hospital, Chinese Academy of Medical Science Beijing China
| | - Mingnan Shi
- Department of Physical Medicine and Rehabilitation Peking Union Medical College Hospital Chinese Academy of Medical Science Beijing China
| | - Man‐Chiu Poon
- Departments of Medicine, Pediatric and Oncology Foothills Medical Center University of Calgary Cumming School of Medicine Calgary AB Canada
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Rodriguez-Merchan EC. The cost of hemophilia treatment: the importance of minimizing it without detriment to its quality. Expert Rev Hematol 2020; 13:269-274. [DOI: 10.1080/17474086.2020.1716726] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Zhang H, Huang J, Kong X, Ma G, Fang Y. Health-related quality of life in children with haemophilia in China: a 4-year follow-up prospective cohort study. Health Qual Life Outcomes 2019; 17:28. [PMID: 30728017 PMCID: PMC6366014 DOI: 10.1186/s12955-019-1083-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 01/07/2019] [Indexed: 11/29/2022] Open
Abstract
Background Health-related quality of life (HRQoL) has been brought up for decades in haemophilia patients. However, no data to date are available about HRQoL in children with haemophilia using long-term follow up data. This nearly 4-year follow-up study aimed to assess the long-term HRQoL of haemophilia children. Methods A prospective cohort study among 42 children with haemophilia and their parents was conducted in August 2014 in a children’s hospital; follow-up was completed in January 2018. Primary endpoint was the change in patient HRQoL evaluated by Canadian Haemophilia Outcomes–Kids’ Life Assessment Tool (CHO-KLAT) from baseline to year 4; secondary endpoint was the impact of bleeding rates, physical activity restriction, financial burden and treatment (prophylaxis vs on-demand treatment) on HRQoL, as well as the impact of treatment on event-free survival. Results Totally 42 patients (mean age, 5.48[SD, 4.63] years) and 42 parents were included. 38 families completed 4-year follow up. Patients reported a small increase in HRQoL from baseline to year 4. The mean scores of child self-report and parent proxy report of CHO-KLAT at baseline were 60.69 (SD = 20.28) and 61.01 (SD = 12.14), respectively. Scores at follow-up were 64.69 (SD = 13.71) and 65.33 (SD = 15.78), respectively. Haemophilia patients without physical activity restriction, living in urban areas, and receiving prophylactic treatment and home injection, had higher average values for HRQoL scores than the others. Bleeding rates were proportionally negatively correlated with HRQoL. Patients who had received prophylactic treatment had better event-free survival. Conclusions Haemophilia decreased HRQoL of patients, but this effect weakened after 4 years. HRQoL of children is influenced by severity of haemophilia, bleeding rates, physical activity restriction, financial burden and treatment. Prophylactic treatment is a key factor contributing to event-free survivor prognosis and the optimal form of therapy for childhood haemophilia.
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Affiliation(s)
- Heng Zhang
- Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Jie Huang
- Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Xiaoyan Kong
- Department of anesthesiology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Gaoxiang Ma
- School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, 211198, China
| | - Yongjun Fang
- Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China.
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