Characterizing female patients with haemophilia A: Administrative claims analysis and medical chart review
- 1 May 2020
- journal article
- review article
- Published by Wiley in Haemophilia
- Vol. 26 (3), 520-528
- https://doi.org/10.1111/hae.13981
Abstract
Aim Haemophilia A (HA) is a male-predominant disorder, yet women and girls can have factor VIII (FVIII) deficiency with bleeding events requiring treatment. This study aimed to identify and characterize female patients with HA. Methods Administrative claims dated 01 January 2012-31 July 2016 were accessed for patients with 18 months' coverage by commercial or Medicare Advantage with Part D insurance. Patients were included by HA diagnoses or treatments and/or bleeding-related diagnoses or procedures, and excluded by haemophilia B or qualitative platelet disorder diagnoses. A sample of charts was examined for bleeding history, HA therapies and bleeding treatments. All-cause healthcare utilization and costs were also described. Results Among 353 patients meeting initial inclusion criteria, 86 charts were procured, with 8 patients identified as having HA. Their mean age was 60 +/- 17 years and most were Medicare-insured. The mean Charlson Comorbidity Index score was 2.50 +/- 2.56; the most prevalent comorbid conditions involved coagulation/haemorrhage, fluid/electrolyte balance and non-traumatic joint disorders. Over 18 months, a mean of 54 ambulatory visits and 120 pharmacy fills were observed; mean medical costs were $86 694 and pharmacy costs were $25 396. Conclusions Identifying females with HA is challenging using healthcare claims, because diagnostic nomenclature is unclear for female patients treated for bleeding events. Although chart abstraction enhanced claims data, very few female patients were identified with HA. Nevertheless, even in a small sample, sizeable burden in comorbidity and healthcare use was observed. Improved nomenclature and coding for HA diagnoses for women and girls is key to improving research and treatment.Funding Information
- Bayer Corporation
This publication has 9 references indexed in Scilit:
- Healthcare costs among patients with hemophilia A treated with factor replacement or bypassing agentsCurrent Medical Research and Opinion, 2019
- Development and Validation of an Algorithm for Identifying Patients with Hemophilia A in an Administrative Claims DatabaseValue in Health, 2018
- Women with bleeding disordersHaemophilia, 2018
- Genotypes, phenotypes and whole genome sequence: Approaches from the My Life Our Future haemophilia projectHaemophilia, 2018
- The spectrum of bleeding in women and girls with haemophilia BHaemophilia, 2017
- Real‐world resource use and costs of haemophilia A‐related bleedingHaemophilia, 2017
- Burden of illness: direct and indirect costs among persons with hemophilia A in the United StatesJournal of Medical Economics, 2015
- Surveillance of female patients with inherited bleeding disorders in United States Haemophilia Treatment CentresHaemophilia, 2011
- Updating and Validating the Charlson Comorbidity Index and Score for Risk Adjustment in Hospital Discharge Abstracts Using Data From 6 CountriesAmerican Journal of Epidemiology, 2011