Hemophilia A – Current Treatment – Detailed, Expanded Analysis (US)

Hemophilia A patients are a heterogeneous cohort. The tendency to bleed is highly individual, resulting in a complex management landscape. Two core therapeutic approaches are employed: (1) prophylaxis, where the aim is to prevent clinically meaningful bleeds through maintaining factor VIII (FVIII) levels, and (2) on-demand treatment, where drugs are utilized at the time of a significant bleed. Various similar FVIII replacement therapies are available (e.g., Takeda’s Advate, Sanofi’s Eloctate). However, some patients develop inhibitors (alloantibodies) that can reduce the effectiveness of FVIII replacement. The launch of Roche’s novel subcutaneous therapy Hemlibra has impacted the hemophilia A +/- inhibitor markets in differing ways. In the noninhibitor space, compelling reasons exist for many hemophilia A patients to remain on FVIII replacement therapies. In contrast, Hemlibra has dramatically altered treatment dynamics in the inhibitor space and has spurred much discussion regarding its merits in the management of newly diagnosed inhibitor patients.


  • What percentage of inhibitor-negative hemophilia A patients have switched from FVIII prophylaxis to Hemlibra? What is the rationale behind this switch?
  • What percentage of patients who were well controlled on FVIII prophylaxis (i.e., the annual bleeding rate is zero) maintain this control after switching to Hemlibra?
  • What percentage of hemophilia A patients are persisting with on-demand FVIII replacement treatment?
  • How do physicians manage newly diagnosed (previously untreated) hemophilia A patients?
  • What percentage of inhibitor-positive hemophilia A patients are on Hemlibra prophylaxis? Is immune tolerance induction (ITI) treatment considered? Do physicians offer ITI treatment?
  • What is the regimen used for ITI? Do patients only receive high-dose FVIII, or they are also given Hemlibra / bypass agents?
  • What is the treatment strategy used after successful ITI? Are patients switched back to FVIII or kept on Hemlibra prophylaxis?
  • How do different product types compare in average weekly units/kg dosing and the number of weekly infusions?


Geographies: United States.

Primary research: Survey of 100 hematologists.

Key drugs covered: Advate, Adynovate, Afstyla, Eloctate, FEIBA, Hemlibra, Jivi, Kogenate, Kovaltry, Novoeight, NovoSeven, Nuwiq.


Current Treatment: Physician Insights provides physician insights on treatment dynamics, prescribing behavior, and drivers of brand use so that marketers can create specific messaging around these treatment dynamics to more effectively increase or defend their market position.

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