Mitigating High-Cost Claims – A Closer Look at Hemophilia

Although hemophilia is a rare disorder affecting about 25,000 people in the US, it ranks among the highest-cost healthcare conditions, averaging $270,000 per claimant annually.1

As with many rare diseases, hemophilia commonly requires lifelong treatment. Because of hemophilia’s low incidence, employers often have little to no understanding of the disease and what makes treatment so costly. Most employers hand off the development of hemophilia cost containment strategies to intermediaries, such as pharmacy benefit managers (PBMs), carriers, TPAs or pharmacy consultants. While these vendors may develop appropriate strategies that result in the lowest total cost of care, conflicts can exist that increase employer costs unnecessarily.