Trends in coagulation factor replacement therapy and medical costs in patients with haemophilia in Taiwan: A population‐based, 15‐year analysis

• Published in: Haemophilia : the official journal of the World Federation of Hemophilia 2021-03, Vol.27 (2), p.e187-e193
• Main Authors: Hsieh, Miyuki Hsing‐Chun, Chiou, Shyh‐Shin, Liao, Tzu‐Chi, Kao Yang, Yea‐Huei, Lai, Edward Chia‐Cheng
• Format: Article
• Language: English
• Subjects: Coagulation; coagulation factor replacement therapy; Costs; haemophilia; Hemophilia; medical cost; Patients; prophylaxis; proportion of days covered; Reimbursement; Trends
• ISSN: 1351-8216; 1365-2516
• DOI: 10.1111/hae.14250

Introduction Taiwan's National Health Insurance Program approved reimbursement of prophylactic coagulation factor replacement therapy (CFRT) for patients with haemophilia (PWH) in 2014. Aim To examine 15‐year trends and the impact of reimbursement for prophylactic CFRT on its utilization and related medical costs for PWH. Methods We analysed Taiwan's National Health Insurance Database from 2003 to 2017. We included patients with haemophilia A (PWHA) or B (PWHB) receiving coagulating factor. Female patients were excluded because of small sample size. We analysed annual consumption of CFRT units and medical costs. High proportion of days covered (PDC) with CFRT served as an indicator for prophylactic treatment since it reflects routine use of CFRT. We applied interrupted time series analysis (ITSA) to evaluate the impact of reimbursement for prophylactic CFRT on usage patterns and medical costs. Results We included 896 male PWHA and 181 male PWHB, with 38.1% and 37.0% aged under 18 years, respectively. By ITSA, we found the trends in coagulation factor consumption and PDC significantly increased after reimbursement for prophylactic CFRT in both PWHA and PWHB (p values for trend change