Surgical comorbidities - a high medical and financial burden for hemophilia care

Abstract

Comorbidity in hemophilia, a pathology non-related to the primary disease, is a relatively new chapter, catching interest along with the revolutionary improvement of the outcomes of this coagulopathy. Aim: As prophylactic replacement therapy has been only recently introduced in our country, we aimed at assessing the frequency and the medical and financial impact of the surgical life-saving interventions of some challenging comorbidities of hemophilia. Material and methods: In the frame of a retrospective observational PRO (Patient Reported Outcomes) model survey conducted on 122 persons with severe congenital coagulopathies in the period of 2019-2020, we focused our attention on surgical comorbidities compared with surgical secondary morbidity. Results: There were performed 17 surgical interventions on 16 patients, 35.95% of them being for comorbidities. The comparative analysis of the two cohorts of patients, with comorbidities versus secondary morbidity, revealed some significant discrepancies: heterogeneity of the pathologic conditions claiming surgery and the modality of its performance, emergency or elective decision. There were registered also some similarities: age of patients and quality of outcomes. What concerns the financial impact, the medical direct costs were also similar. Conclusions: Surgical comorbidities are a high medical and economic burden for hemophilia care, claiming a comprehensive analysis of their approach in order to prospectively find out the best cost-effective and cost-efficient solution on country level for these unexpected, unpredictable diseases.