Abstract
Aim: To determine if emicizumab was channeled to clinically complex people with hemophilia A upon approval. Methods: Claims data (16 November 2017, through 31 December 2019) from US-based insurance databases were analyzed to compare the clinical complexity of people with hemophilia A initiating emicizumab with matched individuals receiving factor VIII (FVIII) episodically or prophylactically. People with hemophilia A with evidence of previous bypassing agent use (indicating FVIII inhibitors) were excluded. Outcomes included bleeding events, arthropathy, pain, comorbidities and healthcare costs. Results: A larger proportion of emicizumab users had bleeding events, comorbidities and arthropathy and greater healthcare costs in the year prior to starting emicizumab compared with FVIII users. Conclusion: Claims-based data limitations prevent an absolute conclusion. Nevertheless, emicizumab users appear more clinically complex than FVIII users, suggesting post-approval channeling.
Original language | English |
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Pages (from-to) | 717-728 |
Number of pages | 12 |
Journal | Journal of Comparative Effectiveness Research |
Volume | 11 |
Issue number | 10 |
Early online date | 10 May 2022 |
DOIs | |
Publication status | Published - Jul 2022 |
Keywords
- INHIBITORS
- PROPHYLAXIS
- REPLACEMENT
- SAFETY
- channeling
- claims data
- coagulation factor VIII
- comorbidity
- emicizumab
- healthcare systems
- hemophilia A
- pharmacovigilance
- safety