PSY65 - REAL-WORLD DATA ANALYSIS OF US CLAIMS DATA ON COAGULATION FACTOR IX DISPENSATION AND EXPENDITURES IN PATIENTS WITH SEVERE HEMOPHILIA B: STANDARD HALF-LIFE VS. EXTENDED HALF-LIFE PRODUCTS

Abstract

Management of hemophilia B requires factor IX (FIX) infusions to replenish missing coagulation factor. Newer extended half-life (EHL) replacement products with longer half-lives compared to standard half-life (SHL) products are available in the US. In this exploratory analysis of US claims data, we compared the expenditures and dispensation of two EHL products versus an SHL product for hemophilia B treatment. De-identified claims from a large national specialty pharmacy dispensation claims database were used to identify male patients with severe hemophilia B who received FIX replacement from May 2016 (first month of albutrepenonacog alfa dispensation) to September 2017 and had ≥1 month of dispensation data. Two patient groups (SHL vs. EHL) were compared. Key outcome measures were direct expenditures and factor IUs dispensed, measured over monthly increments. Descriptive statistics were used to analyze results. Medians for expenditures and IUs were used to accommodate data distribution skewing. 213 Hem B patients met the inclusion criteria and were included in the analysis, including patients who were dispensed >1 FIX product. The SHL (nonacog alfa) group comprised 133 patients; the EHL group included 72 patients in the eftrenonacog alfa group and 39 patients in the albutrepenonacog alfa group. The median per-patient-per-calendar-month FIX product dispensation was 20,456 IU (interquartile range [IQR], 28,896 IU; nonacog) versus 17,438 IU (IQR, 16,483 IU; eftrenonacog) and 10,453 IU (IQR, 8377 IU; albutrepenonacog). Median per-patient-per-calendar-month expenditures were higher for EHLs (eftrenonacog: $51,986, IQR, $49,520; albutrepenonacog: $44,425, IQR, $35,602) than for SHL ($28,025, IQR, $39,587). A consistent pattern of decreased eftrenonacog vs. nonacog unit utilization was not demonstrated. This real-world data analysis showed higher expenditures in US hemophilia B patients who received EHL products. Further analyses, incorporating essential clinical characteristics and drug regimens, should be explored.