Economic Burden of High-Responding Inhibitors in Patients with Hemophilia A in Taiwan.
10.3349/ymj.2013.54.2.358
- Author:
Tsu Chiang TU
1
;
Shin Nan CHENG
;
Jye Daa CHEN
;
Thau Ming CHAM
;
Mei Ing CHUNG
Author Information
1. School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC. meinch@kmu.edu.tw
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Hemophilia;
high-responding inhibitor;
clotting factor concentrate;
cost;
Taiwan
- MeSH:
*Cost of Illness;
*Drug Resistance;
Factor VIII/immunology/therapeutic use;
Hemophilia A/*complications/drug therapy/economics;
Hospitalization/economics;
Humans;
Male;
*Quality of Life;
Retrospective Studies;
Taiwan
- From:Yonsei Medical Journal
2013;54(2):358-365
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Hemophilia A (HA) is the most common X-linked inherited bleeding disorder. In some patients with HA, particularly those with severe HA, replacement therapy results in the production of high-responding clotting factor VIII inhibitors. The economic burden of this complication is the highest reported for a chronic disease. Our aim was to investigate the direct medical expenditure burden of high-responding inhibitors in patients with HA. MATERIALS AND METHODS: A retrospective study was conducted using the National Health Insurance Research Database, utilizing data covering the period of 2004-2007. RESULTS: In total, 638 males with HA, including 37 patients with high-responding inhibitors were evaluated. Over 99% of the annual median medical expenditure was attributable to the cost of clotting factor concentrates (CFCs) in patients with high-responding inhibitors. The annual median expenditure related to CFCs of the total medical care and outpatient care were US$170611 and US$141982, respectively, and were 4.6- and 4.3-fold higher in these patients during the study period, respectively. In patients with high-responding inhibitors, the median hospitalization expenditure and daily hospitalization cost with or without surgical procedures were 3.0- and 2.4-fold higher, respectively, and 4.3 and 5.6-fold higher, respectively. CONCLUSION: Our data reveal higher medical expenditures burden for patients with HA and high-responding inhibitors in Taiwan. Future research is encouraged to evaluate the impact of this burden on patient quality of life.
