Manatt Health Senior Managing Director Anthony Fiori and Senior Manager Nathan Pauly co-authored a research article for the Journal of Managed Care & Specialty Pharmacy examining health care resource use (HCRU), outcomes and costs for Medicaid beneficiaries with hemophilia B receiving factor IX (FIX) prophylaxis therapy.
The study found that Medicaid beneficiaries with hemophilia B receiving FIX prophylaxis had significantly higher rates of HCRU including inpatient hospital admissions and bleeding events, and also had significantly higher costs relative to comparator beneficiaries without bleeding disorders. Additionally, the vast majority of costs among Medicaid beneficiaries with hemophilia B receiving FIX prophylaxis were driven by pharmacy costs associated with FIX therapy. According to the authors, Medicaid agencies should consider these costs when determining coverage related to managed care pharmacy including when developing capitation rates. “Future research should examine hemophilia B costs and outcomes in the context of innovative gene therapies for hemophilia B and should also consider whether Medicaid beneficiaries and other vulnerable populations have equitable access to these treatments,” the authors wrote.
Read the full article here.