Evaluación de costo efectividad de la profilaxis versus tratamiento a demanda en pacientes con Hemofilia A moderada y severa para prevenir sangrado articular de una aseguradora en Colombia

Abstract

Introduction: In Colombia there is a management protocol for patients with severe hemophilia A without inhibitors recommended handling primary and secondary prophylaxis with FVIII. Objectives: To estimate the incremental cost-effectiveness ratio (RICE) prophylaxis with FVIII vs demand treatment to prevent joint bleeding in patients with moderate and severe A hemophilia from an insurer in Colombia. Materials and Methods: A Markov model was adapted from the perspective of the third payer. The transition probabilities were adjusted using a logistic regression model multinomial explained by age and weight. Event rates are annual. The effectivities were removed from the cohort of the insurance and literature. Costs included FVIII, drugs, hospitalization, surgical procedures, diagnostic support and medical consultations. The discount rate was 3%. Results: In patients with moderate and severe hemophilia A prophylaxis with FVIII prevent an average of 7 joint bleeds, bleeding RICE to articulate is $ 303, 457. Conclusions: Prophylaxis with Factor VIII is a cost-effective strategy in the management of patients with hemophilia A moderate and severe for an insurer, decreasing the number of joint bleeds per year.