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Vol 4, No 3 (2011)
Research paper
Published online: 2011-09-23

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Cost comparison of bypassing agents in the treatment of mild to moderate bleeding episodes in patients with congenital haemophilia complicated by inhibitors in Poland

Katarzyna Goszczyńska, Witold Wrona, Maciej Niewada
Journal of Transfusion Medicine 2011;4(3):115-122.


Background: The aim of this study was to evaluate the costs of treatment of mild to moderate bleeding episodes with recombinant activated factor VII (rFVIIa) versus activated prothrombin complex concentrate (aPCC) in adults with haemophilia with inhibitors in Poland.
Materials and methods: The analysis was carried out from the public payer perspective. Only drug acquisition costs (determined by dosage) were identified as parameters differentiating treatment options. There are no country specific data concerning the doses of rFVIIa and aPCC needed to manage bleeding episodes. In the base case analysis parameters from survey carried out among six Polish experts experienced in the treatment of haemophilia complicated by inhibitor were used. Key factors covered: mean weight — 74 kg (range: 70–80); number of bleeding episodes per year — 12.5 (range: 6–20); mean doses of rFVIIa and aPCC needed to manage one bleeding episode: 219 μg/kg (range: 180–270 μg/kg) and 176 IU/kg (range: 100– –300 IU/kg), respectively.
Results: In the base case analysis, the average annual cost of rFVIIa was 571k PLN (range 313–1,140k PLN) and 611k PLN for aPCC (range 354–788k PLN). RFVIIa was associated with higher costs of treatment only in one set of parameters reported by one expert. The lower costs of treatment with rFVIIa than with aPCC were confirmed in three alternative scenarios, based on the best published data.
Conclusions: Cost of annual treatment of mild to moderate bleeding episodes, corresponding to the consumption of bypassing agents in accordance with the opinions of Polish experts, is lower for rFVIIa than for aPCC.
J. Transf. Med. 2011; 3: 115–122

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