An economic model of haemophilia in Mexico

Haemophilia. 2004 Jan;10(1):9-17. doi: 10.1046/j.1365-2516.2003.00811.x.

Abstract

A model was developed to assess the lifetime costs and outcomes associated with haemophilia in Mexico. A retrospective chart review of 182 type A haemophiliacs was conducted for patients aged 0-34 years receiving one of three treatments: (i) cryoprecipitate at clinic; (ii) concentrate at home; or (iii) concentrate at clinic. Patients treated at home experienced 30% less joint damage, used 13-54% less factor VIII, had four times fewer clinic visits, and utilized half as many hospital days than those treated at a clinic. For cryoprecipitate at clinic patients, the annual incidence rates of HCV and HIV were calculated to be 3.6% and 1.4% respectively. The life expectancy for patients receiving cryoprecipitate and those receiving concentrate was estimated to be 49 years and 69 years respectively, with 58% of cryoprecipitate patients predicted to die of AIDS before age 69. Across the lifespan, the average annual cost of care was US$11,677 (MN$110,464) for cryoprecipitate at clinic patients, US$10,104 (M$95,580) for concentrate at home patients and US$18,819 (MN$178,027) for concentrate at clinic patients. Using a 5% discount rate, the incremental lifetime cost per year of life added for treatment with concentrate at home compared with cryoprecipitate at a clinic was US$738 (MN$6981). Rank order stability analysis demonstrated that the model was most sensitive to the cost of fVIII. These results indicate that treatment with concentrate at home compared with cryoprecipitate at a clinic substantially improves clinical outcomes at reduced annual cost levels.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Cost of Illness
  • Costs and Cost Analysis
  • Disabled Persons
  • Factor VIII / economics
  • Fibrinogen / economics
  • Health Resources / economics
  • Hemophilia A / economics*
  • Humans
  • Infant
  • Infant, Newborn
  • Life Expectancy
  • Mexico
  • Models, Economic
  • Regression Analysis
  • Residence Characteristics
  • Retrospective Studies
  • Risk Factors

Substances

  • cryoprecipitate coagulum
  • Factor VIII
  • Fibrinogen