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@article{1183203,
author = {Salaj, Peter and Kubes, Radovan and Cetkovský, Petr and Capova, Irena and Penka, Miroslav and Ovesná, Petra and Mesterton, Johan and Lindgren, Peter},
article_location = {Oxford},
article_number = {2},
doi = {http://dx.doi.org/10.1016/j.thromres.2013.11.002},
keywords = {Haemophilia; NovoSeven (R); rFVIIa; High dose; Costs; Time to treatment},
language = {eng},
issn = {0049-3848},
journal = {Thrombosis Research},
title = {Economic evaluation of rFVIIa high initial dose compared to rFVIIa standard initial dose in patients with haemophilia with inhibitors using the Czech HemoRec registry},
volume = {133},
year = {2014}
}
TY - JOUR
ID - 1183203
AU - Salaj, Peter - Kubes, Radovan - Cetkovský, Petr - Capova, Irena - Penka, Miroslav - Ovesná, Petra - Mesterton, Johan - Lindgren, Peter
PY - 2014
TI - Economic evaluation of rFVIIa high initial dose compared to rFVIIa standard initial dose in patients with haemophilia with inhibitors using the Czech HemoRec registry
JF - Thrombosis Research
VL - 133
IS - 2
SP - 162-167
EP - 162-167
PB - Pergamon-Elsevier Science
SN - 00493848
KW - Haemophilia
KW - NovoSeven (R)
KW - rFVIIa
KW - High dose
KW - Costs
KW - Time to treatment
N2 - Introduction: In the treatment of bleeds in haemophilia patients with inhibitors, a high initial dose of recombinant Factor VIIa (rFVIIa) provides at least equal efficacy and a similar safety profile to a standard initial dose. However, no pharmacoeconomic comparison between these dosing regimens has previously been performed. Here, we assess the pharmacoeconomics of high (> 120 mu g/kg) versus standard (<= 120 mu g/kg) initial rFVIIa dose in inhibitor patients and the impact of time to treatment initiation on costs and outcomes. Methods: In a retrospective analysis, observational data on bleed characteristics, rFVIIa treatment, hospitalizations and outcomes were extracted from the Czech Republic HemoRec registry. Crude comparisons and generalized linear regression modelling (GLM; correcting for patient differences) were performed to compare costs and outcomes between the high and standard initial dosing groups. Results: Of 314 rFVIIa-treated bleeding episodes (12 inhibitor patients), most were spontaneous joint bleeds and 67.5% were treated with a high initial dose. In the crude comparison, high initial rFVIIa dosing was associated with a lower mean number of doses needed to achieve haemostasis compared with standard dosing (p < 0.001), but higher total dose and costs (p <= 0.008). However, regression analyses revealed that high initial dose was associated with similar costs (p = 0.891) and a shorter time to bleeding resolution (p = 0.014). Increasing time to treatment initiation increased both time to bleeding resolution and total costs. Conclusion: Compared with a standard dose, a high initial rFVIIa dose may improve treatment outcomes without increasing costs. Early treatment initiation may reduce treatment costs.
ER -
SALAJ, Peter, Radovan KUBES, Petr CETKOVSKÝ, Irena CAPOVA, Miroslav PENKA, Petra OVESNÁ, Johan MESTERTON and Peter LINDGREN. Economic evaluation of rFVIIa high initial dose compared to rFVIIa standard initial dose in patients with haemophilia with inhibitors using the Czech HemoRec registry. \textit{Thrombosis Research}. Oxford: Pergamon-Elsevier Science, 2014, vol.~133, No~2, p.~162-167. ISSN~0049-3848. Available from: https://dx.doi.org/10.1016/j.thromres.2013.11.002.
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