OBJECTIVES: With 5,050 Egyptians living with hemophilia (2013), the standard of care management is still on-demand with Recombinant activated factor VII (rFVIIa, eptacog alfa activated), the objective of the analysis is to calculate the budget impact of introducing the anti-Inhibitor coagulant complex (FEIBA) to the public sector formulary in Egypt, for the treatment of acute bleeding episodes and for surgery coverage in patients with hemophilia with inhibitors.

METHODS: An Excel based budget impact model was designed measuring the impact of using Feiba in controlling the bleeding episodes of Hemophilia patients with inhibitors in On-demand setting and in pre-operative management. The model accounted only for direct medical costs including the acquisition price of medications; Feiba and eptacog alfa, bleed management costs and costs of pre and post operations use of medications. Clinical approach in bleed control and pre-operative management was captured through local experts opinion. The model was built over a 5-year time horizon with an increased uptake of Feiba over time. One way sensitivity analysis was run to evaluate the robustness of the outcome.

RESULTS: The model was run on an estimated prevalence of 1,236 hemophilia patients with inhibitors in the first year and considered the disease incidence over 5 years. In the base case scenario of the model, including both adults and pediatrics populations, Feiba showed an estimated total saving of 5,571,386,296 EGP (296,918,055 USD) over the 5 years, compared to the current use of eptacog alfa. This saving is mainly attributed to the lower dosage and frequency needed by Feiba in bleed control and preoperative management.

CONCLUSIONS: Despite its higher acquisition price, Feiba adoption would result in a significant budget saving compared to the current standard of care. The results of this model would inform decision makers for efficient resources allocation in the field of Hemophilia care in Egypt.