SOCIOECONOMIC IMPACT OF HEMOPHILIA CARE - RESULTS OF A PILOT-STUDY

Fifty consecutive haemophiliacs were entered into a pilot study of soc ioeconomic impact of haemophilia treatment. The Short Form 36 was used as an instrument for the assessment of quality of life. Direct and in direct costs were analysed. Incremental cost-effectiveness was express ed as additional costs per joint bleed avoided by prophylactic treatme nt over on-demand treatment. Thirty-nine patients (mean age 35.14 year s) were substituting factor VIII according to an on-demand and 11 pati ents according to a modified prophylactic regimen. There were an avera ge of 9.84 joint bleeds per patient across all patients during the 6-m onth observation period: on-demand group 10.74 bleeds, prophylactic gr oup 6.64 bleeds. This difference was not statistically different. Sign ificant differences between haemophiliac patients and healthy men were seen in the assessment of their limitations of physical activities, l imiting pain and general health. The total cost per patient during the 6 months was DM 24 601 in all patients, DM 17 253 in those on an on-d emand base and DM 28 245 in the modified prophylactic group. Patients experienced an average 4.71 days off work: on demand 5.81 days, prophy lactic regimen 0 days. The total indirect cost per patient was DM 683; therapy cost per patient was DM 25 284; cost per avoided bleed DM 168 0 for on-demand therapy and DM 4228 on prophylaxis. The incremental co st-effectiveness, i.e. the additional costs to avoid one additional jo int bleed by prophylactic treatment, was DM 2536. In conclusion, patie nts receiving prophylactic clotting factor therapy require less additi onal health care resources, mainly due to the reduction in the number of joint bleeds.