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dc.contributor.authorLi, Nanxin
dc.contributor.authorSawyer, Eileen K
dc.contributor.authorMaruszczyk, Konrad; orcid: 0000-0002-0173-5020
dc.contributor.authorGuzauskas, Greg; orcid: 0000-0002-9095-1672
dc.contributor.authorSlomka, Marta T
dc.contributor.authorBurke, Tom
dc.contributor.authorMartin, Antony P
dc.contributor.authorO'Hara, Jamie
dc.contributor.authorStevenson, Matt
dc.contributor.authorRecht, Michael
dc.date.accessioned2021-03-02T01:53:59Z
dc.date.available2021-03-02T01:53:59Z
dc.date.issued2021-02-16
dc.identifierpubmed: 33591884
dc.identifierdoi: 10.1080/13696998.2021.1891088
dc.identifier.citationJournal of medical economics, page 1
dc.identifier.urihttp://hdl.handle.net/10034/624298
dc.descriptionFrom PubMed via Jisc Publications Router
dc.descriptionPublication status: aheadofprint
dc.description.abstractHemophilia B (HB) is a rare congenital disorder characterized by bleeding-related complications which are managed by prophylactic or post-bleeding event ("on-demand") replacement of clotting factor IX (FIX). The standard of care for severe HB is life-long prophylaxis with standard half-life (SHL) or extended half-life (EHL) products given every 2-3 or 7-14 days, respectively. FIX treatment costs in the US have been investigated, but the lifetime costs of HB treatment have not been well characterized, particularly related to the impact of joint health deterioration and associated health resource utilization. We developed a decision-analytic model to explore outcomes, costs and underlying cost drivers associated with FIX treatment options over the lifetime of an adult with severe or moderately severe HB. With participation from clinicians, health technology assessment specialists and patient advocates, a Markov model was constructed to estimate bleeding events and costs associated with health states including 'bleed into joint', 'bleed not into joint', 'no bleed' and death. Sub-models of joint health were based on 0, 1, or ≥2 areas of chronic joint damage. US third-party payer and societal perspectives were considered with a lifetime horizon; sensitivity analyses tested the robustness of primary findings. Total adult lifetime costs per patient with severe and moderately severe HB were $21,086,607 for SHL FIX prophylaxis, $22,987,483 for EHL FIX prophylaxis, and $20,971,826 for on-demand FIX treatment. For FIX prophylaxis, the cost of FIX treatment account for >90% of the total HB treatment costs. This decision analytic model demonstrated significant economic burden associated with the current HB treatment paradigm.
dc.languageeng
dc.sourceeissn: 1941-837X
dc.subjectFIX
dc.subjectMarkov
dc.subjectburden
dc.subjectcost
dc.subjecthemophilia
dc.titleAdult lifetime cost of hemophilia B management in the US: Payer and societal perspectives from a decision analytic model.
dc.typearticle
dc.date.updated2021-03-02T01:53:59Z


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