Channeling effects in the prescription of new therapies: the case of emicizumab for hemophilia A
Publication: Journal of Comparative Effectiveness Research
Abstract
Aim: To determine if emicizumab was channeled to clinically complex people with hemophilia A upon approval. Methods: Claims data (16 November 2017, through 31 December 2019) from US-based insurance databases were analyzed to compare the clinical complexity of people with hemophilia A initiating emicizumab with matched individuals receiving factor VIII (FVIII) episodically or prophylactically. People with hemophilia A with evidence of previous bypassing agent use (indicating FVIII inhibitors) were excluded. Outcomes included bleeding events, arthropathy, pain, comorbidities and healthcare costs. Results: A larger proportion of emicizumab users had bleeding events, comorbidities and arthropathy and greater healthcare costs in the year prior to starting emicizumab compared with FVIII users. Conclusion: Claims-based data limitations prevent an absolute conclusion. Nevertheless, emicizumab users appear more clinically complex than FVIII users, suggesting post-approval channeling.
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Pages: 717 - 728
PubMed: 35535702
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© 2022 The Authors. This work is licensed under the Attribution-NonCommercial-NoDerivatives 4.0 Unported License
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Received: 8 November 2021
Accepted: 13 April 2022
Published online: 10 May 2022
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Channeling effects in the prescription of new therapies: the case of emicizumab for hemophilia A. (2022) Journal of Comparative Effectiveness Research. DOI: 10.2217/cer-2021-0278
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