Clinical Burden and Healthcare Resource Use Among Adults Living with Hemophilia A: An Observational Study.

Abstract

Introduction: People with hemophilia A (PwHA) may suffer from repeated bleeding in muscles and joints. However, few studies have reported disease burden and healthcare resource utilization (HCRU) in PwHA experiencing bleeding events and/or joint disorders in a real-world setting. The aim of this study was to examine disease burden and HCRU in PwHA via two different categorizations: PwHA with and without medically recorded bleeding (MRB), and PwHA with and without joint disorders.

Methods: This was an observational cross-sectional study of adult male PwHA treated with factor VIII replacement therapy, identified from PharMetrics Plus^® claims data between 2010 and 2019. Comorbidities prevalence and HCRU rates were described. Rate ratios (RRs) of HCRU between PwHA with and without MRB, and PwHA with and without joint disorders were estimated using multivariate adjusted Poisson or negative binomial regressions.

Results: There were 1961 PwHA identified. Of those, 1045 had MRB and 352 had arthropathy. PwHA with MRB showed a higher prevalence of comorbidities and HCRU compared with those without MRB, including inpatient admissions, emergency department visits, outpatient visits, factor VIII replacement therapy, and pain relief medications use. PwHA with MRB also had high bleeding-related HCRU; bleeding-related events accounted for 46% of inpatient hospitalizations. Similarly, PwHA with joint disorders had a higher comorbidity burden and HCRU than those without joint disorders.

Conclusions: PwHA with concurrent bleeding/joint disorders had higher clinical burden compared with those without MRB or joint disorders. Treatment approaches to reduce bleeding episodes, and consequently joint damage, in PwHA may reduce clinical burden.