Real-World Analysis of Patients with Haemophilia A And Haemophilia A Carriers in The United States: Demographics, Clinical Characteristics, and Costs

Authors: Batt, K; Xing, S; Kuharic, M; Bullano, M; Caicedo, J; Chakladar, S; Markan, R; Farahbakhshian, S

Affiliations: Sprouts Consulting Ltd., Raleigh, North Carolina, USA. Takeda Pharmaceuticals U.S.A., Inc., Lexington, Massachusetts, USA. Department of Pharmacy Systems, Outcomes and Policy, University of Illinois at Chicago, Chicago, Illinois, USA. Complete HEOR Solutions (CHEORS), North Wales, Pennsylvania, USA.

Publication: Haemophilia; 2023

Abstract: INTRODUCTION: Females with haemophilia A (HA [FHAs]) and HA carriers (HACs) have an increased risk of bleeding and complications compared to the general population. AIM: To examine the characteristics, billed annualized bleed rates (ABR(b)), costs and healthcare resource utilization for males with HA (MHAs), FHAs and HACs in the United States. METHODS: Data were extracted from the IBM® MarketScan® Research Databases (Commercial and Medicaid) for claims during the index period (July 2016 to September 2018) and analyzed across MHAs, FHAs and HACs. RESULTS: Dual diagnosis females (DDFs; both HA and HAC claims) were grouped as a separate cohort. MHAs were generally younger than females (all cohorts) by up to 19 years (Commercial) and 23 years (Medicaid). ABR(b) >0 was more frequent in females. Factor VIII claims were higher for MHAs versus female cohorts. Joint-related health issues were reported for 24.4 and 25.6% (Commercial) and 29.3 and 26.6% (Medicaid) of MHAs and FHAs, respectively; lower rates were reported in the other two cohorts. Heavy menstrual bleeding claims occurred for approximately a fifth (Commercial) to a quarter (Medicaid) of female cohorts. All-cause emergency department and inpatient visits in FHAs and DDFs were similar to, or more frequent than, those in MHAs; bleed-related inpatient visits were infrequent. In MHAs (Commercial), mean all-cause total costs ($214,083) were higher than in FHAs ($40,388), HACs ($15,647) and DDFs ($28,320) with similar trends for Medicaid patients. CONCLUSIONS: FHAs and HACs may be undermanaged and undertreated. Further research is needed to fully understand these cohorts’ bleeding rates, long-term complications, and costs.