Several recombinant factors VIII (rFVIII) with extended half-life (EHL) have recently been approved in Italy. The present analysis aims to estimate the annual cost of treatment of the EHL rFVIIIs reimbursed in Italy.

The perspective of the National Healthcare Service (NHS) was adopted. For each regimen, a literature review was conducted to find the latest available studies reporting the mean annual IU (international unit) consumption. From the calculation of the mean annual IU consumption, annual treatment costs were estimated by using the prices published in the Italian Official Journals and an average weight per patient of 70kg.

Compared to turoctocog alfa and efmoroctocog alfa, rurioctocog alfa pegol is the drug associated with the lowest mean annual IU consumption: 4,343 IU for rurioctocog alfa pegol, 4,550 IU for turoctocog alfa and 4,878 IU for efmoroctocog alfa. This was translated into an annual cost per patient of about €219,000 for rurioctocog alfa pegol, €229,000 for turoctocog alfa and €246,000 for efmoroctocog alfa.

The adoption of rurioctocog alfa pegol produces a predictable budget forecast, representing a sustainable option for the NHS, in addition to its effectiveness. Further analyses considering real world dosages are needed to confirm the findings of the present work.