AMCP Market Insights: Summit on Hemophilia
Findings from an AMCP Market Insights Program
Recent therapeutic advances in hemophilia have led to a wave of new FDA-approved agents, and with it concerns of growing costs for managing the disease. By some estimates, the hemophilia category is nearly $11 billion, with signs of increasing compounded annual growth. In light of increasing specialty spend in this category, health plans are beginning to consider identifying opportunities to implement care optimization and cost management strategies. However, due to the complexity of treatment and the current care models, health plans need to understand the current business models in place, and the potential impact on patient care and decisions. AMCP convened an expert forum of stakeholders representing hemophilia treatment centers, specialty pharmacies, advocacy, clinicians, and health plans to discuss the current patient care and business models in delivering care to members with hemophilia in an effort to identify areas for more efficient care delivery. Participants discussed coverage and reimbursement models in hemophilia, cost drivers, coordination of care, and recommendations for implementing changes in care delivery to manage rising costs.