Characterisation of healthcare utilisation and cost of haemophilia care in real-life: A 4-year follow-up study in Finland

Hanna Ventola, Aino Vesikansa, Jari Jokelainen, Timo Siitonen, Pia Ettala, Outi Laine, Elina Lehtinen, Aino Lepäntalo, Maria Patronen, Anu Partanen, Miika Linna, Tero Ylisaukko-oja, Riitta Lassila*

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Introduction: Characterisation of outcomes and costs of haemophilia care in common practice settings is essential for evaluation of new treatment options and for developing clinical practices. In Finland, haemophilia care is mostly centralised to University Hospitals, but treatment practices and costs in adult patients have not been systematically evaluated. Aim: This study was designed to characterise healthcare resource utilisation and treatment costs of adult inhibitor-negative haemophilia patients managed in Finnish University Hospitals. Methods: The study was based on a nationwide cohort, which consists of all adult haemophilia A (HA; n = 120) and B (HB; n = 35) patients treated in University Hospitals from 2012 to 2016. Patient characteristics and data on healthcare utilisation and factor replacement use were collected from medical records. Direct costs of care were evaluated based on wholesale drug prices and healthcare service utilisation with standard unit costs. Results: Most of HA (79%, n = 96) and HB (84%, n = 31) patients received factor replacement therapy. The median annual bleeding rate (ABR) was low, at 0.8 for HA and 0.5 for HB, also among the patients with on-demand therapy. Over 94% (n = 149) of the patients had outpatient visits during the follow-up period. The mean total annual costs of treatment ranged from €2520 to €176,330. The highest individual cost was factor replacement therapy. Conclusion: The outcomes of centralising the management of care to University Hospital Treatment Centres show low ABR and lower treatment costs compared with earlier reports from other high-income European populations. Management strategies, including choosing the right therapy between prophylaxis and on-demand, has been successful in Finland.

Original languageEnglish
Number of pages10
JournalHAEMOPHILIA
Early online date2020
DOIs
Publication statusPublished - 20 Nov 2020
MoE publication typeA1 Journal article-refereed

Keywords

  • cost
  • factor replacement therapy
  • haemophilia A
  • haemophilia B
  • healthcare
  • treatment

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