PB0659 - Medically Recorded Bleeds and Healthcare Resource Use in the United States Among Adult Males With Hemophilia A

Background: Repeated bleeding in muscles and joints are major causes of morbidity and disability in people with hemophilia A (PwHA).

Aims: Examine all-cause and arthropathy-related healthcare resource use (HRU) and comorbidities in PwHA with medically recorded bleeds (MRB).

Methods: PwHA (adult males 19-64 years of age) prescribed factor VIII replacement therapy were identified from US PharMetrics Plus® health insurance claims data from 01/01/2010 to 12/31/2019. This analysis was sponsored by Pfizer. Exclusions included moderate or severe liver disease diagnoses as well as evidence of inhibitor. MRB included hemarthrosis, intracerebral hemorrhage, gastrointestinal bleeding, and other symptomatic bleeds that could be identified using relevant diagnostic codes. Poisson (or negative binomial) regression was used to estimate rates and rate ratios [RR] of all-cause inpatient admissions and emergency room (ER) visits, and joint surgery between PwHA with and without MRB. Hemophilia severity was not coded in the data.

Results: PwHA with MRB (n=1045) were more likely to have significant comorbidities (eg, mild chronic liver disease, anxiety, and depression) compared with PwHA without MRB (n=916). The number of all-cause inpatient admissions in PwHA with MRB was 14.6 per 100 person-years, nearly 3 times higher than PwHA without MRB after adjustment for demographic and clinical characteristics, including major comorbidities (adjusted RR: 2.6, 95% CI: 2.0-3.3). The number of all-cause ED visits in PwHA with MRB was 61.6 per 100 person-years, more than 3 times higher than PwHA without MRB (adjusted RR: 3.1, 95% CI: 2.6-3.7). The number of joint surgeries in PwHA with MRB was 7.4 per 100 person-years, nearly 4 times higher than PwHA without MRB (adjusted RR: 3.7, 95% CI: 2.5-5.4).

Conclusion(s): Significant disease burden is incurred by adult PwHA experiencing bleeding events, underscoring the need for treatment advances in this population.