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Social/economic costs and quality of life in patients with haemophilia in Europe

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Abstract

Objective

The aim of this study was to determine the economic burden from a societal perspective and the health-related quality of life (HRQOL) of patients with haemophilia in Europe.

Methods

We conducted a cross-sectional study of patients with haemophilia from Bulgaria, France, Germany, Hungary, Italy, Spain Sweden and the UK. Data on demographic characteristics, health resource utilisation, informal care, loss of labour productivity and HRQOL were collected from the questionnaires completed by patients or their caregivers. HRQOL was measured with the EuroQol 5-domain (EQ-5D) questionnaire. The costs have been estimated from a societal perspective adopting a bottom-up approach.

Results

A total of 401 questionnaires were included in the study, of which 339 were collected from patients with haemophilia and 62 from caregivers. The lowest average annual cost per person was reported in Bulgaria (€6,660) and the highest in Germany (€194,490). Our results demonstrate both a large difference from country to country in the average annual cost per patient in 2012 and the driving role of drugs in costs. Drugs represent nearly 90 % of direct healthcare costs in a majority of the countries analysed (Hungary, Italy, Spain and Germany). In Bulgaria, France and Sweden, however, healthcare services (visits, tests and hospitalisations) prevail. Costs are also shown to differ between children and adults. The mean EQ-5D index score for adult patients was 0.69 and mean EQ-5D VAS was 66.6. The mean EQ-5D index score for carers was 0.87 and mean EQ-5D VAS was 75.5. In the disability score, 60 % showed no disability and measuring caregiver burden with the Zarit Index produced an overall mean score of 25.3.

Conclusion

We have shown that haemophilia is associated with a substantial economic burden and impaired HRQOL. Studies on cost of illness and HRQOL are important for haemophilia as the future of this disease is likely to change with the development of new innovative treatments. The introduction of these treatments will most likely impact future costs related to haemophilia.

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Acknowledgments

The authors wish to thank: National Alliance of People with Rare Diseases (NAPRD), Bulgaria; Alliance Maladies Rares, France; ACHSE, Germany; Hungarian Federation of People with Rare and Congenital Diseases (RIROSZ), Hungary; Federazione Italiana Malattie Rare (UNIAMO), Italy; the Consulta Nazionale delle Malattie Rare, Italy; Rare Diseases Sweden; Federación Española de Efermedades Raras (FEDER), Spain; Rare Disease UK and Rare Diseases Europe (EURORDIS); Bulgarian Haemophilia Society; Association française des hémophiles, France; Interessengemeinschaft Hämophiler e.V., Germany; Magyar Hemofília Egyesület, Hungary; FEDEMO—Federazione delle Associazioni Emofilici ONLUS and A.E.L.—Associazione emofilici del Lazio, Italy; Swedish Hemophilia Society, Sweden; Asociación Andaluza de Hemofilia Canf Cocemfe and Asociaciónde Hemofilia de la Comunidad de Madrid, Spain; Haemophilia Society, UK.

Author information

Authors and Affiliations

  1. Centre for Research on Health and Social Care Management (CERGAS), Bocconi University, Via Roentgen 1, 20136, Milan, Italy

    Marianna Cavazza, Patrizio Armeni & Giovanni Fattore

  2. National Centre for Rare Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy

    Yllka Kodra, Marta De Santis & Domenica Taruscio

  3. University of Castilla-La Mancha, Talavera de la Reina, Toledo, Spain

    Julio López-Bastida

  4. Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain

    Julio López-Bastida, Renata Linertová, Juan Oliva-Moreno & Pedro Serrano-Aguilar

  5. Fundación Canaria de Investigación Sanitaria (FUNCANIS), Las Palmas de Gran Canaria, Spain

    Renata Linertová

  6. University of Castilla-La Mancha, Toledo, Spain

    Juan Oliva-Moreno

  7. Evaluation and Planning Service at Canary Islands Health Service, Santa Cruz de Tenerife, Spain

    Pedro Serrano-Aguilar

  8. Institute of Rare Diseases Research, ISCIII, SpainRDR & CIBERER, Madrid, Spain

    Manuel Posada-de-la-Paz

  9. “Aldo and Cele Daccò” Clinical Research Center for Rare Diseases, Mario Negri Institute for Pharmacological Research, Ranica (Bergamo), Italy

    Arrigo Schieppati

  10. Institute of Rare Diseases, Plovdiv, Bulgaria

    Georgi Iskrov

  11. Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary

    László Gulácsi

  12. Centre for Health Economics Research Hannover (CHERH), Leibniz Universität Hannover, Hanover, Germany

    Johann Matthias Graf von der Schulenburg

  13. Department of Social Policy and LSE Health, London School of Economics and Political Science, London, UK

    Panos Kanavos

  14. URC Eco Ile de France, AP-HP, Paris, France

    Karine Chevreul

  15. The Swedish Institute for Health Economics, Lund, Sweden

    Ulf Persson

  16. Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria

    Georgi Iskrov

  17. Université Paris Diderot, Sorbonne Paris Cité, ECEVE, UMRS 1123, Paris, France

    Karine Chevreul

  18. INSERM, ECEVE, U1123, Paris, France

    Karine Chevreul

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  1. Marianna Cavazza
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  2. Yllka Kodra
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  3. Patrizio Armeni
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  4. Marta De Santis
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  11. Arrigo Schieppati
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  13. László Gulácsi
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  14. Johann Matthias Graf von der Schulenburg
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  17. Ulf Persson
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  18. Giovanni Fattore
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BURQOL-RD Research Network

Corresponding author

Correspondence to Marianna Cavazza.

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Funding

Supported by the Social/Economic Burden and Health-Related Quality of Life in Patients with Rare Diseases in Europe Project, which received funding from the European Union within the framework of the Health Programme (grant A101205). The Executive Agency of the European Union is not responsible for any use that may be made of the information contained herein.

Conflict of interest

The authors declare that they have no conflicts of interest.

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Members of the BURQOL-RD Research Network listed in the Supplementary Annex 1.

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Cavazza, M., Kodra, Y., Armeni, P. et al. Social/economic costs and quality of life in patients with haemophilia in Europe. Eur J Health Econ 17 (Suppl 1), 53–65 (2016). https://doi.org/10.1007/s10198-016-0785-2

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  • DOI: https://doi.org/10.1007/s10198-016-0785-2

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