Costs, Economic Burden Higher Among Hemophilia A Carriers

Hemophilia A is a genetic bleeding disorder primarily affecting males, but females can also be carriers of the condition. While females are often considered asymptomatic carriers, they can experience mild to severe bleeding events. 

A new study published online in the JMCP aimed to compare the clinical characteristics, health care resource utilization, and costs incurred by hemophilia A carriers with a non-carrier female control group in the United States.

The researchers conducted a retrospective observational cohort study using data from the IBM MarketScan Commercial Claims and Encounters and Multi State Medicaid Databases. The study period spanned from January 1, 2016, to September 30, 2019. The hemophilia A carrier patients were matched with a non-carrier female control group in a 1:2 ratio based on sociodemographic characteristics, pregnancy status, and insurance type. The researchers evaluated the billed annualized bleed rates, health care resource utilization, and annualized costs. They used generalized linear models to compare the annualized total costs between the hemophilia A carrier and control groups.

After matching, the study included 121 hemophilia A carrier patients from the commercial database and 55 from the Medicaid database, each matched with two control patients. The results showed that patients in the hemophilia A carrier group had higher rates of joint-related health issues compared to the control group. However, they had lower rates of soft-tissue disorders. The prevalence of musculoskeletal pain was slightly higher in the hemophilia A carrier group in the commercial database but slightly lower in the Medicaid database. Billed annualized bleed rates were higher in the hemophilia A carrier group, indicating a greater frequency of bleeding episodes.
Furthermore, the study found that significantly more patients in the hemophilia A carrier group experienced minor and spontaneous bleeds compared to the control group. 

Health care resource utilization was primarily through outpatient visits for both groups, but the hemophilia A carriers had higher utilization rates for all-cause and bleed-related claims. While less frequent, emergency department and inpatient visits followed a similar trend.

The economic burden of hemophilia A carriers was also evident in the study. In both the commercial and Medicaid databases, hemophilia A carriers incurred approximately twice the mean all-cause healthcare total costs compared to the control group. These increased costs were attributed to higher outpatient, emergency department, and inpatient visits.

In conclusion, this study demonstrates that hemophilia A carriers experience more complications and incur higher health care costs compared to non-carrier females. The findings highlight the disease and economic burden faced by hemophilia A carriers and suggest that early diagnosis and management are essential for preventing long-term complications. 

By understanding the clinical characteristics and health care utilization patterns of hemophilia A carriers, health care providers can provide appropriate care and support to alleviate the burden on these patients.

Reference:
Xing S, Batt K, Kuharic M, et al. Evaluation of clinical characteristics, health care resource utilization, and cost outcomes of hemophilia A carriers and noncarriers in the United States: A real-world comparative analysis. J Manag Care Spec Pharm. 2023;29(6):626-634. doi:10.18553/jmcp.2023.29.6.626