Patients with hemophilia A benefit from preventive use of newer FDA-approved extended half-life therapies
ORLANDO, Fla., March 26, 2019 /PRNewswire/ -- A recent study found patients with hemophilia A experienced fewer bleeds while undergoing newer extended half-life (EHL) therapy on a prophylactic (preventive) basis. The retrospective study was conducted by AllianceRx Walgreens Prime, a leading central specialty and home delivery pharmacy, in collaboration with the Duquesne University School of Pharmacy.
Hemophilia A is a rare genetic disorder caused by a deficient or defective clotting protein called factor VIII (FVIII). The disorder is characterized by spontaneous bleeds into joints and muscles, causing inflammation which may lead to joint damage. To treat the condition, the missing FVIII must be replaced. Treatment is often in the form of standard half-life (SHL) products, which have proven to be safe and effective. Patients with severe hemophilia are typically prescribed prophylactic therapy to reduce their number of bleeds. This means patients take enough medication to maintain adequate levels of FVIII in the bloodstream, thereby preventing a bleed.
While effective, treatment with SHL products may negatively impact patient quality of life due to the inconvenience of infusing three to four times weekly. Extended half-life (EHL) products, though newer and costlier than SHL products, mean patients may infuse only one to two times per week. This study aimed to compare SHL and EHL products on patient outcomes such as efficacy, safety, cost and usage.
During the study, researchers analyzed records of 109 AllianceRx Walgreens Prime specialty pharmacy patients taking an FDA-approved SHL or EHL FVIII product for prophylactic treatment of hemophilia A. The study included 59 patients taking FDA-approved SHL products (Advate®, Helixate FS®, Kogenate FS®, Kovaltry®) and 50 patients taking FDA-approved EHL products (Elocate®, Adynocate®) from Jan. 1, 2017 to Dec. 31, 2018.
Patients on an EHL regiment had a statistically significant lower annualized bleed rate (ABR) than those on a SHL regimen, according to Michael McCall, PharmD, PGY-1 resident at AllianceRx Walgreens Prime, lead author/analyst of the study. "In addition to the outcome related to ABR, we also wanted to look at how these medications impacted a patient's quality of life," says McCall. "We evaluated pain they experienced related to their bleeding disorder, any missed work or school due to a bleed, hospitalizations and the use of mobility accessories, such as a cane or wheelchair. There was no statistical difference in those factors when we compared SHL to EHL therapies."
Due to the high average wholesale price of the EHL drugs, researchers conducted a second analysis to determine the difference in monthly insurance and patient copays. While EHL products are costlier, findings showed that patients only paid a small fraction of the list price. And, further analysis showed that Adynovate, one of the EHL therapies, was not statistically costlier when compared to the SHL drugs.
"The greatest impact of this study for patients is the control over their bleeds," says McCall. "If they're reluctant to switch to an EHL drug because they're not sure of its efficacy, they can be reassured they will not only decrease their infusion frequency but also have better control over, and fewer bleeds."
Rick Miller, vice president of clinical and professional services at AllianceRx Walgreens Prime, says the findings are significant for the treatment of hemophilia but come at a high price. "From a payer viewpoint, these clinical improvements come with higher medication costs. This reinforces the importance of individualized treatment, patient monitoring, and drug selection."
The team of co-authored researchers will present these findings at the Academy of Managed Care Pharmacy (AMCP) Managed Care and Specialty Pharmacy 2019 Annual Meeting on March 25-28, 2019 in San Diego.
About AllianceRx Walgreens Prime
AllianceRx Walgreens Prime (alliancerxwp.com) is a specialty and home delivery pharmacy that strives to provide exceptional care throughout a patient's treatment journey with the medications they need every day. Formed in 2017 through a collaboration between Walgreens, one of the nation's largest chain drug stores, and Prime Therapeutics, a leading pharmacy benefit manager, the company offers tools and resources for patients, providers and health plans to deliver the optimal health outcomes. The company is headquartered in Orlando, Fla. and its pharmacies are accredited by several national pharmacy accreditation services.
AllianceRx Walgreens Prime
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