Biotechnology Healthcare - November/December 2008 - (Page 37) To Manage Costs of Hemophilia, Patients Need More Than Clotting Factor BY CRYSTAL S. BLANKENSHIP, PharmD Accredo Health Services With the cost of clotting factor exceeding $50,000 a year, careful management can save payers thousands of dollars per patient. The author writes about the role specialty pharmacy plays in cost management while helping patients achieve better clinical outcomes. I mprovements in medical care have allowed people with hemophilia to live longer, healthier lives, yet hemophilia remains one of the most costly and complex conditions to manage. Primary treatment involves infusing the patient with a clotting factor, costing tens of thousands of dollars annually. Given the complexity of the disorder, the cost of treatment, and the growing number of patients, it is critical for health plans and employers to manage hemophilia cases effectively. Specialty pharmacies can play a critical role as partners with the treating physician, family, and health plan by managing therapy, supplying pharmaceuticals, providing support to patients and families, and coordinating insurance coverage. HEMOPHILIA POPULATION According to the National Heart, Lung, and Blood Institute, about Crystal S. Blankenship, PharmD, has assisted patients as a national clinical therapy specialist for Hemophilia Health Services, an Accredo Health Subsidiary, for more than a year. Previously, she was a clinical pharmacist at Summit Medical Center, in Hermitage, Tenn., for six years. She obtained her PharmD from Auburn University. 18,000 Americans are diagnosed severe cases of the disorder can with hemophilia, and 400 children bleed spontaneously. Even a seemare born each year with this genetic ingly minor injury requires interdisorder (NIH 2007). During the vention. 1980s, clotting factor manufactured from human blood had inadequate THERAPY MANAGEMENT viral inactivation, resulting in rela- PROCESS As with other chronic conditions tively high mortality rates caused that involve expensive by such bloodborne infections as HIV and hepatitis treatments, hemophilia reC. The impact of this can quires a high-touch apbe seen today in that the proach to patient care. The hemophilia population is therapy management skewed toward the young; process includes diagnoonly 1 in 7 patients with sis, selection and evaluhemophilia are 45 years ation of treatment, and of age or older (CDC Crystal S. psychosocial support for 2008). Given that today’s Blankenship, the patient. A physician PharmD clotting factors are either must collaborate with recombinant or plasma-derived nurses, pharmacists, social workproducts that undergo extensive ers, and other members of the care purification and viral inactivation, team. the life expectancy of people with Specialty pharmacies also play a hemophilia is closer to that of a role as part of the treatment team, healthy adult. providing not just clotting factor, Though mortality risks have de- but also drug utilization manageclined, the disability risk for patients ment, patient education, and seris still relatively high because the vices that promote adherence to disorder is characterized by bleed- therapy and improved outcomes. ing into muscles and joints, which Specialty pharmacies combine can lead to chronic pain and joint medical and pharmacy information disease. While it is common for into integrated data networks to give people with hemophilia to bleed as clinicians a holistic view of patient a result of an injury, patients with health that can guide the delivery of NOVEMBER/DECEMBER 2008 · BIOTECHNOLOGY HEALTHCARE 37
For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.