Cost effectiveness of prophylactic treatment with activated prothrombin complex concentrate in a patient with inhibitor-positive hemophilia A.
Patients with hemophilia and high titers of inhibitors are hard to treat during bleeding events and consequently are more likely to incur high treatment costs and to experience deterioration in quality of life. We report here the case of a boy with hemophilia A and high titers of inhibitors who responded well to prophylactic activated prothrombin complex concentrate (APCC) treatment. Previously, he had to be hospitalized frequently because of painful bleeding of target joints of the knee and ankle. At the age of 4 years and 3 months, APCC prophylaxis at a dose of 60 U/kg, three times a week, was initiated together with on-demand therapy with recombinant factor VIIa. This reduced the frequency and severity of bleeding and ended the need for hospitalization. This, together with a decreased requirement for bypass agents, APCC treatment significantly reduced the cost of treatment for this patient.
Department of Pediatrics, Jichi Medical University School of Medicine, Tochigi, Japan.
Sachie
S
Nakamura
Akira
A
Morimoto
Yukiko
Y
Oh
Tomomi
T
Hayase
Yoshifumi
Y
Kashii
Yuji
Y
Gunji
Mariko Y
MY
Momoi
D019774:Blood Coagulation Factor Inhibitors / Q000032:analysis; D001779:Blood Coagulation Factors / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D015942:Factor VIIa / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D006467:Hemophilia A / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000191:economics*; D006470:Hemorrhage / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000191:economics*; D006760:Hospitalization; D006801:Humans; D007596:Joints / Q000187:drug effects; D008297:Male; D011516:Prothrombin / Q000032:analysis; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use
D019774:Blood Coagulation Factor Inhibitors; D001779:Blood Coagulation Factors; D011994:Recombinant Proteins; C025667:prothrombin complex concentrates; D011516:Prothrombin; C103587:recombinant FVIIa; D015942:Factor VIIa