@article{353e29629fb3456ead32376092640d52,
title = "Channeling effects in the prescription of new therapies: the case of emicizumab for hemophilia A",
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.",
keywords = "INHIBITORS, PROPHYLAXIS, REPLACEMENT, SAFETY, channeling, claims data, coagulation factor VIII, comorbidity, emicizumab, healthcare systems, hemophilia A, pharmacovigilance, safety",
author = "Arash Mahajerin and Imi Faghmous and Peter Kuebler and Monet Howard and Tao Xu and Carlos Flores and Tiffany Chang and Francis Nissen",
note = "Funding Information: This study was funded by F Hoffmann-La Roche Ltd. None of the authors received honoraria or fees for their contribution to the development of this manuscript or the supplementary material. F Nissen is a current employee of F Hoffmann-La Roche Ltd. I Faghmous is a previous employee of F Hoffmann-La Roche Ltd. and Gilead Sciences, Inc. P Kuebler is a current employee of and holds shares in Genentech, Inc. M Howard is a previous contract employee of Genentech, Inc.; is a current employee of and holds shares in F Hoffmann-La Roche Ltd.; and has received expenses from Genentech, Inc. T Xu is a previous employee of AG Pharma and current employee of F Hoffmann La-Roche Ltd. and has received expenses from AG Pharma and F Hoffmann La-Roche Ltd. C Flores is a current employee of Genesis Research. T Chang is a previous employee of Genentech, Inc., and current employee of Spark Therapeutics. A Mahajerin has been on a speakers{\textquoteright} bureau for Alexion Pharmaceuticals; Spark Therapeutics; and Genentech, Inc. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. Publisher Copyright: {\textcopyright} 2022 The Authors.",
year = "2022",
month = jul,
doi = "10.2217/cer-2021-0278",
language = "English",
volume = "11",
pages = "717--728",
journal = "Journal of Comparative Effectiveness Research",
issn = "2042-6305",
publisher = "Future Medicine Ltd.",
number = "10",
}