Hemophilia is a rare genetic disorder that impacts the body’s ability to form blood clots due to missing or low levels of proteins known as clotting factors. The condition impacts up to 33,000 men in the United States, according to the Centers for Disease Control and Prevention (CDC), and more than 2,700 women, also according to the CDC. It disproportionately affects men because the genes responsible for the condition are associated with the X chromosome, of which men only have one.  

While advancements in treatment options have improved the quality and length of life for those with hemophilia, one treatment — known as prophylaxis, or infusions of medications that prevent bleeding episodes — can be costly, sometimes more than $600,000 per year, according to research published in the Journal of Managed Care and Specialty Pharmacy. Similarly, CSL Behring’s etranacogene dezaparvovec-drlb (Hemgenix^®) was approved by the U.S. Food and Drug Administration (FDA) in 2022 for treating hemophilia B and is priced at $3.5 million, and BioMarin Pharmaceuticals’s valoctocogene roxaparvovec-rvox (Roctavian^®) was approved in 2023 for treating hemophilia A and is priced at $2.9 million. Prime Therapeutics (Prime) commercial medical and pharmacy claims data from last year indicates it’s the 14th most expensive drug category. In addition to experiencing the high cost of treatment, patients may also have trouble following treatment plans, a lack of individualized treatment and fragmentation of care between treatment centers and pharmacies.  

That’s where Prime's HighTouchRx^® product can help.  

HighTouchRx relies on clinical and predictive modeling to identify high-cost members and suggest interventions to lower drug costs. For example, the product can show when too much of a medication is being dispensed when a lower amount would be effective or can identify and recommend eliminating duplicate therapies. It also offers opportunities for payers to partner with clinical pharmacists to provide individualized, high-touch outreach, which helps support Prime’s mission of providing the kind of care we’d want for our loved ones.  

Since April 2022, HighTouchRx has saved commercial and Medicare plans more than $150 million, according to Prime internal data.  

“Lowering the cost of hemophilia treatments means giving patients the chance to live without the constant fear of figuring out how they’ll afford their critical medications,” said Haita Makanji, PharmD, vice president, clinical strategy and innovation at Prime. “It’s about ensuring that every person with hemophilia can focus on living their life to the fullest.”  

Prime offers several other solutions, products and features that can help support those with hemophilia, including packaged hemophilia management solutions, gene therapy management, Prime’s Expert Clinical Network, Best in Care^® and more. Packaged hemophilia solutions are rooted in clinical expertise, analytics and a holistic view of member health, helping to manage this disorder through personalized therapy, increased transparency and data collection, and pharmacy inventory and assay management. This comprehensive solution has generated more than $40 million in savings since 2017.  

Learn more about how Prime helps clients and members manage hemophilia  

World Hemophilia Day 

Prime is honored to join the bleeding disorders community to recognize World Hemophilia Day, which brings awareness to the condition and treatment. This year’s theme, “Access for all: Women and girls bleed too,” aims to bring awareness to an underserved and underrecognized demographic to help advocate for better awareness, treatment and care. Learn more at WFH.org/World-Hemophilia-Day.