Personalized Prophylaxis with myPKFiTCE: A Real-World Cost-Effectiveness Analysis in Haemophilia A Patients

被引:0
作者
Antonazzo, Ippazio Cosimo [1 ,2 ]
Cortesi, Paolo Angelo [1 ,2 ]
Zanon, Ezio [3 ]
Pasca, Samantha [4 ]
Morfini, Massimo [5 ]
Santoro, Cristina [6 ]
De Cristofaro, Raimondo [7 ]
Di Minno, Giovanni [8 ]
Cozzolino, Paolo [1 ]
Mantovani, Lorenzo Giovanni [1 ,2 ]
机构
[1] Univ Milano Bicocca, Res Ctr Publ Hlth CESP, I-20900 Monza, Italy
[2] IRCCS Ist Auxol Italiano, I-20145 Milan, Italy
[3] Univ Hosp Padua, Hemophilia Ctr, I-35128 Padua, Italy
[4] Padua Univ Hosp, Dept Biomed Sci, Lab Med, I-35128 Padua, Italy
[5] Italian Assoc Haemophilia Ctr AICE, I-50100 Florence, Italy
[6] Umberto I Univ Hosp, Hematol, I-00161 Rome, Italy
[7] Catholic Univ, A Gemelli Hosp, Sch Med, Dept Med Sci,Ctr Haemorrhag & Thrombot Dis, I-00168 Rome, Italy
[8] Univ Naples Federico II, Reg Serv Ctr Coagulat Disorders, Dept Clin Med & Surg, I-80138 Naples, Italy
来源
MEDICINA-LITHUANIA | 2024年 / 60卷 / 01期
关键词
hemophilia A; health economics; pharmacokinetics-guided; prophylaxis; RECOMBINANT FACTOR-VIII; INDIVIDUALIZING PROPHYLAXIS; STANDARD PROPHYLAXIS; DRIVEN PROPHYLAXIS; FOLLOW-UP; EXPERIENCE; CHILDREN; OUTCOMES; PHARMACOKINETICS; SWEDEN;
D O I
10.3390/medicina60010034
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background and Objectives: This study aimed to assess the effectiveness and costs associated with pharmacokinetics-driven (PK) prophylaxis based on the myPKFiT (R) device in patients affected by hemophilia A (HA) in Italy. Materials and Methods: An observational retrospective study was conducted in three Italian hemophilia centers. All patients with moderate or severe HA, aged >= 18 years, capable of having PK estimated using the myPKFiT device, and who had had a clinical visit between 1 November 2019 and 31 March 2022 were included. Differences in clinical, treatment, health resources, and cost data were assessed comparing post-PK prophylaxis with pre-PK. The incremental cost-effectiveness ratio (ICER) was estimated as cost (EUR) per bleed avoided. Results: The study enrolled 13 patients with HA. The mean annual bleeding rate decreased by -1.45 (-63.80%, p = 0.0055) after the use of myPKFiT (R). Overall, the consumption of FVIII IU increased by 1.73% during follow-up compared to the period prior the use of the myPKFiT. Prophylaxis based on the myPKFiT resulted in an ICER of EUR 5099.89 per bleed avoided. Conclusions: The results of our study support the idea that the use of PK data in clinical practice can be associated with an improvement in the management of patients, as well as clinical outcomes, with a reasonable increase in costs.
引用
收藏
页数:10
相关论文
共 46 条
[1]  
Ahlberg A., 1965, Acta Orthop Scand Suppl, P3
[2]   A 6-year follow-up of dosing, coagulation factor levels and bleedings in relation to joint status in the prophylactic treatment of haemophilia [J].
Ahnström, J ;
Berntorp, E ;
Lindvall, K ;
Björkman, S .
HAEMOPHILIA, 2004, 10 (06) :689-697
[3]   A LONGITUDINAL-STUDY OF ORTHOPEDIC OUTCOMES FOR SEVERE FACTOR-VIII-DEFICIENT HEMOPHILIACS [J].
ALEDORT, LM ;
HASCHMEYER, RH ;
PETTERSSON, H ;
EIBL, H ;
GILBERT, M ;
HILGARTNER, M ;
KUNSHACK, M ;
LARRIEU, MJ ;
LEVINE, P .
JOURNAL OF INTERNAL MEDICINE, 1994, 236 (04) :391-399
[4]   Experience of tailoring prophylaxis using factor VIII pharmacokinetic parameters estimated with myPKFiT® in patients with severe haemophilia A without inhibitors [J].
Alvarez-Roman, M. T. ;
Fernandez-Bello, I. ;
de la Corte-Rodriguez, H. ;
Hernandez-Moreno, A. L. ;
Martin-Salces, M. ;
Butta-Coll, N. ;
Rivas-Pollmar, M. I. ;
Rivas-Munoz, S. ;
Jimenez-Yuste, V. .
HAEMOPHILIA, 2017, 23 (01) :E50-E54
[5]  
[Anonymous], 1964, 18 WMA GEN ASSEMBLY
[6]   A comparison of MyPKFiT and WAPPS-Hemo as dosing tools for optimizing prophylaxis in patients with severe haemophilia A treated with Octocog alfa [J].
Arvanitakis, Alexandros ;
Berntorp, Erik ;
Astermark, Jan .
HAEMOPHILIA, 2021, 27 (03) :417-424
[7]   US Hemophilia Treatment Center population trends 1990-2010: patient diagnoses, demographics, health services utilization [J].
Baker, J. R. ;
Riske, B. ;
Drake, J. H. ;
Forsberg, A. D. ;
Atwood, R. ;
Voutsis, M. ;
Shearer, R. .
HAEMOPHILIA, 2013, 19 (01) :21-26
[8]   Consensus perspectives on prophylactic therapy for haemophilia:: summary statement [J].
Berntorp, E ;
Astermark, J ;
Björkman, S ;
Blanchette, VS ;
Fischer, K ;
Giangrande, PLF ;
Gringeri, A ;
Ljung, RC ;
Manco-Johnson, MJ ;
Morfini, M ;
Kilcoyne, RF ;
Petrini, P ;
Rodriguez-Merchan, EC ;
Schramm, W ;
Shapiro, A ;
Van Den Berg, HM ;
Hart, C .
HAEMOPHILIA, 2003, 9 :1-4
[9]   Prophylactic dosing of factor VIII and factor IX from a clinical pharmacokinetic perspective [J].
Björkman, S .
HAEMOPHILIA, 2003, 9 :101-108
[10]   Comparative pharmacokinetics of plasma- and albumin-free recombinant factor VIII in children and adults: the influence of blood sampling schedule on observed age-related differences and implications for dose tailoring [J].
Bjorkman, S. ;
Blanchette, V. S. ;
Fischer, K. ;
Oh, M. ;
Spotts, G. ;
Schroth, P. ;
Fritsch, S. ;
Patrone, L. ;
Ewenstein, B. M. ;
Collins, P. W. .
JOURNAL OF THROMBOSIS AND HAEMOSTASIS, 2010, 8 (04) :730-736