Economic burden of high-responding inhibitors in patients with hemophilia A in Taiwan.
OBJECTIVE
Hemophilia A (HA) is the most common X-linked inherited bleeding disorder. In some patients with HA, particularly those with severe HA, replacement therapy results in the production of high-responding clotting factor VIII inhibitors. The economic burden of this complication is the highest reported for a chronic disease. Our aim was to investigate the direct medical expenditure burden of high-responding inhibitors in patients with HA.


METHODS
A retrospective study was conducted using the National Health Insurance Research Database, utilizing data covering the period of 2004-2007.


RESULTS
In total, 638 males with HA¸ including 37 patients with high-responding inhibitors were evaluated. Over 99% of the annual median medical expenditure was attributable to the cost of clotting factor concentrates (CFCs) in patients with high-responding inhibitors. The annual median expenditure related to CFCs of the total medical care and outpatient care were US$170611 and US$141982, respectively, and were 4.6- and 4.3-fold higher in these patients during the study period, respectively. In patients with high-responding inhibitors, the median hospitalization expenditure and daily hospitalization cost with or without surgical procedures were 3.0- and 2.4-fold higher, respectively, and 4.3 and 5.6-fold higher, respectively.


CONCLUSIONS
Our data reveal higher medical expenditures burden for patients with HA and high-responding inhibitors in Taiwan. Future research is encouraged to evaluate the impact of this burden on patient quality of life.
School of Pharmacy, Kaohsiung Medical University, No 100 Shi-Chuan 1st Road, Kaohsiung 807, Taiwan, ROC.
Tsu-Chiang
TC
Tu
Shin-Nan
SN
Cheng
Jye-Daa
JD
Chen
Thau-Ming
TM
Cham
Mei-Ing
MI
Chung
D017281:Cost of Illness; D004351:Drug Resistance; D005169:Factor VIII / Q000276:immunology / Q000627:therapeutic use; D006467:Hemophilia A / Q000150:complications* / Q000188:drug therapy / Q000191:economics; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D011788:Quality of Life; D012189:Retrospective Studies; D013624:Taiwan
D005169:Factor VIII