Coverage Decisions for Expensive Hemophilia Treatments

EP: 1.Management Insights for Patients With Hemophilia

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EP: 2.Coverage Decisions for Expensive Hemophilia Treatments

EP: 3.Impact of ICER Reports on Hemophilia Treatment Decisions

EP: 4.Enhancing Provider Access and Expertise for Rare Disease Care

EP: 5.Factors Impacting Hemophilia A Care Costs

EP: 6.Collaborative Strategies in Hemophilia A Care Cost Management

EP: 7.Strategies to Manage Medication Costs and Waste

EP: 8.Adapting to Novel Hemophilia A Treatments

EP: 9.Comprehensive Insights into Hemophilia A: Prevalence, Clinical Impact, and Economic Considerations

EP: 10.Evolution of the Hemophilia A Treatment Landscape: Innovations and Guidelines

EP: 11.Hemophilia A Treatment Factors and Outcomes

EP: 12.Prophylactic Treatment Challenges and Considerations for Hemophilia A

EP: 13.Consequences of Nonadherence in Hemophilia A

EP: 14.Advancements in Hemophilia A Therapies

EP: 15.Comparing Hemophilia A Therapies: Efficacy and Safety Insights

EP: 16.Real-World Insights: Factor vs Emicizumab in Hemophilia A

EP: 17.Emicizumab Dosing: Prophylaxis and Bleeding Management

EP: 18.Optimizing Hemophilia Treatment: Strategies and Adherence

EP: 19.Advancements in Hemophilia A Therapies: Altuviiio and Roctavian

EP: 20.Advancements in Hemophilia A Treatment: Fitusiran and the Evolving Landscape

Russell P. Gollard, MD, FACP: Regarding the types of coverage for these patients, we have not had a lot of denials for the newer treatments. Many of these patients are receiving very, very expensive types of drug therapies, and these are all covered. The plan covers these medications, and there is an existing 340B program through the hemophilia treatment center where these patients can obtain the drugs.There are many considerations taken into account when we prescribe a medicine. We consider the total cost of care, coverage, and the availability of the drug on an ongoing basis. Usually, our specialty pharmacies and our local hemophilia treatment center can tell us what looks like is going to be available to patients for a long time.

Real-world evidence is something that’s changing on a daily basis. We like to look at some of the newer therapies, including gene therapies, as possibilities for treatment in the future, knowing that ultimately the only cure for hemophilia is going to be gene therapy. We also want to look at some of the newer mechanisms of treatment through which some of these new treatments have been developed, and in that way, we like to give patients really what is on the cutting edge of treatment, both in terms of efficacy and in preventing side effects, which have been, unfortunately, a part of treatment for hemophilia for some years, including some years ago, infectious agents such as HIV back in the 1980s. Then when we were, in fact, using prothrombin factor complexes in the time before monoclonal agents were available, there was a great concern regarding blood clots, that is, reversing the proclivity to bleed too much.

Transcript is AI generated and reviewed by an AJMC editor.