2016, Number 1
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Gac Med Mex 2016; 152 (1)
Economic impact of hemophilia type A and B in Mexico
Carlos-Rivera F, Gasca-Pineda R, Majluf-Cruz A, García-Chávez J
Language: Spanish
References: 32
Page: 19-29
PDF size: 109.39 Kb.
ABSTRACT
Background: The treatment of hemophilia generates a disproportionally large economic impact relative to its prevalence.
Objective: To determine the economic impact of hemophilia A and B in Mexico in 2011 from the perspective of public health
institutions.
Methods: Hemophilia was epidemiologically characterized in Mexico during the year of interest, direct costs
(diagnosis, monitoring or follow-up, care of bleeding events, and consumption of hemostatic factors), as well as absenteeism
associated with illness (indirect costs) were estimated. Records, surveys and official data were supplemented by expert
opinion to assess costs.
Results: The investment in hemostatic factors is the primary source of cost: 68.6 and 74.3% of
total investment in hemophilia A and B, respectively. Sensitivity analysis showed that the most decisive variable is the cost
of acquisition of hemostatic factors, including bypass agents. The second most important source of cost is the attention to
bleeding events, being significantly higher in patients receiving on-demand treatment compared with those receiving
prophylaxis.
Conclusion: In Mexico, hemophilia is a condition whose treatment requires a large amount of financial resources
associated with the cost of hemostatic factors and care of hemorrhage, the latter being lower in patients on prophylaxis
relative to on-demand.
REFERENCES
Globe DR, Curtis RG, Koerper MA; HUGS Steering Committee. Utilization of care in haemophilia: a resource-based method for cost analysis from the Haemophilia Utilization Group Study (HUGS). Haemophilia. 2004;10 Suppl 1:63-70.
Di Minno MN, Di Minno G, Di Capua M, et al. Cost of care of haemophilia with inhibitors. Haemophilia. 2010;16:190-201.
Escobar MA. Health economics in haemophilia: a review from the clinician’s perspective. Haemophilia. 2010;16 Suppl 3:29-34.
Guh S, Grosse SD, McAlister S, et al. Healthcare expenditures for males with haemophilia and employer-sponsored insurance in the United States, 2008. Haemophilia. 2012;18:268-75.
Guh S, Grosse SD, McAlister S, et al. Health care expenditures for Medicaid-covered males with haemophilia in the United States, 2008. Haemophilia. 2012;18:276-83.
Knight C, Danø AM, Kennedy-Martin T. A systematic review of the costeffectiveness of rFVIIa and APCC in the treatment of minor/moderate bleeding episodes for haemophilia patients with inhibitors. Haemophilia. 2009;15:405-19.
Pokras SM, Petrilla AA, Weatherall J, et al. The economics of inpatient on-demand treatment for haemophilia with high-responding inhibitors: a US retrospective data analysis. Haemophilia. 2012;18:284-90.
Barr RD, Saleh M, Furlong W, et al. Health status and health-related quality of life associated with hemophilia. Am J Hematol. 2002;71: 152-60.
Aledort L, Bullinger M, von Mackensen S, et al;Health Related Quality of Life Expert Working Group of the International Prophylaxis Study Group. Why should we care about quality of life in persons with haemophilia? Haemophilia. 2012;18:e154-7.
Poon JL, Zhou ZY, Doctor JN, et al. Quality of life in haemophilia A: Hemophilia Utilization Group Study Va (HUGS-Va). Haemophilia. 2012; 18:699-707.
Srivastava A, Brewer AK, Mauser-Bunschoten EP, et al; Treatment Guidelines Working Group The World Federation Of Hemophilia. Guidelines for the management of hemophilia. Haemophilia. 2013;19:e1-47.
Siddiqi AE, Ebrahim SH, Soucie JM, et al. Burden of disease resulting from hemophilia in the U.S. Am J Prev Med. 2010;38(4 Suppl):S482-8.
Diagnóstico y tratamiento de hemofilia pediátrica. México: Secretaría de Salud; 2009. [Actualización 2012].
Diagnóstico y tratamiento de hemofilia en adultos. México: Secretaría de Salud; 2009.
Memoria de Actividades 2009-2011. México: Federación de Hemofilia de la República Mexicana, A.C.; 2012.
World Federation of Hemophilia. Report on the Annual Global Survey; 2011.
SINAIS. Sistema Nacional de Información en Salud. Disponible en: http:// www.sinais.salud.gob.mx/basesdedatos/.
Diario Oficial de la Federación. Instituto Mexicano del Seguro Social. Acuerdo ACDO.SA2.HCT.010611/155.P.DF., dictado por el H. Consejo Técnico en la sesión ordinaria celebrada el 1 de junio del presente año, relativo a la Aprobación de los Costos Unitarios por el Nivel de Atención Médica para el año 2011; 14 junio 2011.
Noone D, O’Mahony B, Prihodova L. A survey of the outcome of prophylaxis, on-demand or combined treatment in 20–35 year old men with severe haemophilia in four European countries. Haemophilia. 2011;17: e831-48.
Den Uijl IEM, Fischer K, Van Der Bom JG, et al. Clinical outcome of moderate haemophilia compared with severe and mild haemophilia. Haemophilia. 2009;15:83-90.
Pipe S. Antihemophilic factor (recombinant) plasma/albumin-free method for the management and prevention of bleeding episodes in patients with hemophilia A. Biologics. 2009;3:117-25.
Nagel K, Walker I, Decker K, et al. Comparing bleed frequency and factor concentrate use between haemophilia A and B patients. Haemophilia. 2011;17:872-4.
Instituto Mexicano del Seguro Social. GRD – IMSS Producto Hospitalario. 1ª ed.; 2011.
Diario Oficial de la Federación. Instituto Mexicano del Seguro Social. Acuerdo ACDO.SA3.HCT.200313/65.P.DF., dictado por el H. Consejo Técnico en la sesión ordinaria celebrada el 20 de marzo de 2013, relativo a la Aprobación de los Costos Unitarios por el Nivel de Atención Médica para el año 2013; 20 marzo 2013.
Instituto Mexicano del Seguro Social. Portal de compras del IMSS. Disponible en: http://compras.imss.gob.mx/?P=search_alt.
Secretaría de la Función Pública. Portal de compras del gobierno federal CompraNet. Disponible en: https://compranet.funcionpublica.gob. mx/web/login.html.
Instituto Nacional de Estadística y Geografía. Mujeres y Hombres en México 2011. [México]: Instituto Nacional de Estadística y Geografía, Instituto Nacional de las Mujeres, 2012. Disponible en:
Instituto Nacional de Estadística y Geografía. Consulta interactiva de datos. Encuesta Nacional de Ocupación y Empleo (ENOE). Conjunto de datos: Indicadores (Promedios). Disponible en: http://www.inegi.org.mx/ sistemas/olap/proyectos/bd/consulta.asp?p=27608&c=27221&s=est&- cl=4# [consultado: 10 junio 2013].
Manco-Johnson MJ, Abshire TC, Shapiro AD, et al. Prophylaxis versus episodic treatment to prevent joint disease in boys with severe hemophilia. N Engl J Med. 2007;357:535-44.
Richards M, Williams M, Chalmers E, et al. Paediatric Working Party of the United Kingdom Haemophilia Doctors’ Organization. A United Kingdom Haemophilia Centre Doctors’ Organization guideline approved by the British Committee for Standards in Haematology: Guideline on the use of prophylactic factor VIII concentrate in children and adults with severe haemophilia A. Br J Haematol. 2010;149:498-507.
Gringeri A, Lundin B, von Mackensen S, et al.; ESPRIT Study Group. A randomized clinical trial of prophylaxis in children with haemophilia A (the ESPRIT study). J Thromb Haemost. 2011;9:700-10.
Iorio A, Marchesini E, Marcucci M, et al. Clotting factor concentrates given to prevent bleeding and bleeding-related complications in people with hemophilia A or B. Cochrane Database Syst Rev. 2011;9: CD003429.