title: Health economic review of recombinant activated factor VII for treatment of bleeding episodes in hemophilia patients with inhibitors.
abstract: Severe hemophilia with inhibitors is a rare disease with substantial clinical, humanistic and economic consequences. This review provides an overview of the role of recombinant activated factor VII (rFVIIa) versus plasma-derived bypassing agents for hemophilia with inhibitors and summarizes the 13 formal economic analyses (6 burden of illness and 7 comparative studies) that have been published in this indication. The findings suggest that the economic impact of rFVIIa has occurred primarily during hospitalization to manage major bleeding episodes and to allow for elective orthopedic surgeries that would not have been attempted prior to rFVIIa. Comparative analyses for on-demand treatment suggest that the total cost of treating a bleeding episode with rFVIIa may be lower than with plasma-based agents due to faster bleeding resolution, higher initial efficacy rates and avoidance of second and third lines of treatment.
authors.affiliation: Pharmerit North America LLC, 7272 Wisconsin Ave, Suite 300, Bethesda, MD 20814-4858, USA. jstephens@pharmerit.com
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Stephens
authors.forename: Ashish V
authors.initials: AV
authors.lastname: Joshi
authors.forename: Michael
authors.initials: M
authors.lastname: Sumner
authors.forename: Marc F
authors.initials: MF
authors.lastname: Botteman
mesh_terms: D019774:Blood Coagulation Factor Inhibitors; D003029:Coagulants / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use*; D016527:Drug Costs; D005167:Factor VII / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use*; D015942:Factor VIIa; D006467:Hemophilia A / Q000150:complications / Q000188:drug therapy* / Q000191:economics; D002836:Hemophilia B / Q000150:complications / Q000188:drug therapy / Q000191:economics; D006470:Hemorrhage / Q000188:drug therapy* / Q000191:economics / Q000209:etiology; D006801:Humans; D011994:Recombinant Proteins / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D019774:Blood Coagulation Factor Inhibitors; D003029:Coagulants; D011994:Recombinant Proteins; D005167:Factor VII; C103587:recombinant FVIIa; D015942:Factor VIIa