Costo Efectividad del Empleo de Factor VIII / Factor de von Willebrand (Wilate) en el Tratamiento de la Enfermedad de von Willebrand

Abstract

Abstract General Objective To determine the average incremental relation and cost-effectiveness of the use of Wilate® in the treatment of spontaneous bleeding and prophylaxis in von Willebrand patients (VWD) who do not respond to DDAVP or type 2 and 3, in comparison with antihemophilic factor available in the National Health System Formulary. Introduction Von Willebrand disease (VWD) is characterized by a bleeding defect of genetic origin, which affects both, men and women with an estimated worldwide prevalence of 1%. In Mexico, these numbers are unknown. VWD presents a diversity of 20 biological subtypes. Treatment of these patients is mainly focused in controlling and prophylaxis of the acute or spontaneous bleeding. For the latter we have several alternatives that can be found in the National Health System Formulary (cuadro básico de salud), such as desmopressin, which is a effective among VW type 1 patients (with a frequency of 60% to 80%), FVIII/VWF blood concentrates (antihemophilic factor) indicated for hemophilia treatment, for patients which do not respond to desmopressin or do not have any production of VWF (VWD type 2 and 3), blood products like cryoprecipitates which are effective in controlling or preventing bleeding. Conclusions The present evaluation identified gains in health and the costs associated as a consequence to treat patients with a plasma concentrate with VWF like Wilate®, compared to the actual treatment available in the public health sector (antihemophilic factor). In this setting, Wilate®, offers 14% more probabilities to prevent bleedings when used as a prophylactic agent and 13% more in controlling acute bleedings than treatment with antihemophilic factor.