Latest Evidence in Comparison of Factor Products

Mar 5, 2019
A real world evidence study by Accredo compares consumption, cost, and bleed rate for hemophilia patients transitioning to extended half-life factor product.
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  • Hemophilia

 Man Oncology TRC

In recognition of bleeding disorders awareness month, we highlight this condition with the results of a recent study comparing hemophilia therapies, as well as the clinical care provided by our specialist pharmacists, nurses and patient care advocates in the Bleeding Disorders Therapeutic Resource Center (TRC).

Approximately one in 10,000 people in the U.S. are born with hemophilia or another form of bleeding disorder, a rare genetic condition in which blood doesn’t clot normally, because it lacks sufficient blood-clotting protein.

With treatment, patients receive the appropriate clotting factor (factor VIII or factor IX) which is administered intravenously to stop or prevent bleeding. Factor is manufactured from two sources: donated blood plasma or recombinant (manufactured using little or no human proteins.)

Standard half-life (SHL) factor products have been available in various forms for many years. In recent years, a number of extended half-life (EHL) products have been approved for both hemophilia A and B, which allows for longer intervals between IV infusions. With fewer infusions needed, patients and caregivers are not as restricted to a therapy regimen that can greatly impact school, work, vacations, and free time.

Real World Evidence Comparison Study

Our study looked at adults who switched products in the first three years of EHL market availability and had 12 continuous months of dispenses from Accredo: 6 months immediately before the switch and 6 months immediately after.

The study concluded that people with hemophilia A who switched to a factor VIII EHL product saw:

  • An increase in number of units consumed from 287,540 annually to 369,140 (+28.4%)
  • Increased mean annual cost from $551,527 to $924,813 (+67.7%)
  • A decrease in annual bleed rate from 3.54 to 1.84 (-51.9%)

By contrast, people with hemophilia B who switched to an EHL product saw:

  • A decrease in number of units consumed from 302,173 annually to 240,322 (-20.5%)
  • Increased mean annual cost from $478,096 to $921,291 (+92.7%)
  • A decrease in annual bleed rate from 2.89 to 1.48 (-51.3%)

Currently, Accredo is reviewing this information to understand the patient’s clinical course during product switching and obtaining greater insight into which patients benefit clinically versus those patients who had little benefit but experienced higher cost of care.

Complex Treatment Requires Expert Clinical Care

Factor products are high in cost to treat a rare and complex disease, so appropriate management of these therapies is important to reduce waste and increase adherence.  We do this by:

  • Assay variance: Experienced pharmacists who work with hemophilia treatments every day calculate the right amount of a therapy to ensure dosing, which is based on the weight of a patient, is clinically relevant and to dispense the right amount of factor to avoid financial waste. Accredo is an industry leader in assay variance through our large inventory of factor medications.
  • Proprietary scoring programs: Through two algorithm-based scoring programs, we’re able to analyze clinical and psychosocial aspects of patient reported information that influences outcomes. We tailor monitoring and support of patients based on their individual score. Our algorithms are designed to capture experiences common to all patients as well as elements that may be unique to each patient in order to guide patients toward the best treatment and outcome.

Education and Support

Hemophilia can be a difficult diagnosis for a family to receive, especially because the majority of the newly diagnosed cases are in babies. While hemophilia is a genetic condition, approximately one-third of new diagnoses occur in people with no family history. Often, there is a lot of misunderstanding associated with this condition.

Accredo has created educational initiatives and support programs for patients of all ages, including:

  • Hemophilia.com, which provides the latest in patient and provider resources and includes free downloadable guides for emergency care providers, coaches, educators, and caregivers. Also on the site is an educational video for children as well as materials describing what patients and caregivers need to know about bleeding disorders at every stage of life, from newborn to adulthood. 
  • Karing for Kids®, is an innovative, educational program designed to teach young people about bleeding disorders through interactive workshops. These sessions incorporate a variety of learning tools, such as music, art, activities, and books. The program is offered in small group settings, as well as schools, to help a patient’s classmates and teachers better understand what it means to live with a bleeding disorder.
Through extensive knowledge of treatments and a deep understanding of patient needs, Accredo has become one of the largest providers of bleeding disorder products and services in the country. We’re committed to raising awareness of bleeding disorders and helping patients experience the healthiest outcomes possible.

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