Estimation of the budget impact of the dual dispensing circuit of emicizumab in France: The HemiValue study

Hemophilia A is a rare bleeding disorder associated with an economic burden for patients and their caregivers. This study, called HemiValue, consists in a budget impact model to assess the benefits for patients and the budgetary impact of this shift to dual dispensing for all stakeholders involved, comparing the cost and time savings from the patients' perspective and from the pharmacies' perspective. Methodology: The impact of the dual dispensing circuit over one year was evaluated from the patients' perspective, the evaluation included costs, travel and waiting times related to obtaining the treatment, as well as associated income losses. The analysis also included perspectives from hospital pharmacies (HP), community pharmacies (CP), and ecological considerations. Results: On an individual level, the availability of emicizumab in CP reduced the time spent obtaining this treatment by the equivalent of 3 working days per year. The 322 euros difference in direct costs per year represents a reduction in the proportion of costs relative to the available income of families from 2.6% to 0.2%. This reduction was more pronounced for low-income households and those living more than 30 min from a HP. Discussion: The dual dispensing circuit reduces the financial and logistical burdens associated with obtaining emicizumab. These results highlight the importance of innovative dispensing models that aim to ease constraints for patients and their caregivers while working towards greater equity in accessibility.