A total of 64 patients, 70 caregivers and 48 HCPs (21 haematologi

A total of 64 patients, 70 caregivers and 48 HCPs (21 haematologists and 27 nurses) completed the survey (Table 2). The mean patient age was 22.4 years old, with the mean age for the patient group at 34.6 years old and for the caregiver group at

11.2 years old. The majority of patients were caucasian/White (n = 107; 80%), had severe haemophilia A (n = 126; 94%), were treated prophylactically (n = 108; 81%), and the majority of patients and caregivers received some college education. On average, HCPs had 21 years of experience in treating haemophilia A patients, and 96% (n = 46 of 48) of participating HCPs were affiliated with an HTC, with the majority of the HTCs locating in urban areas. Approximately 60% (n = 29) of participating http://www.selleckchem.com/products/MK-2206.html HCPs treated more than 20 severe haemophilia A patients in the year preceding the survey. Seventy three of 134 (54%) patients indicated that the recent economic downturn had a negative impact on their haemophilia A-related care. HCPs reported that access to care for their patients with haemophilia A was slightly (73%) or significantly negatively (19%) impacted by the economic downturn. Furthermore, 81% (39 of 48) of HCPs indicated that their ability to treat their haemophilia A patients was impacted by the economic downturn. Of the 73 patients indicating that the economic downturn negatively impacted their haemophilia care,

70 made financially related treatment modification decisions. As shown in Fig. 1, the most common treatment modifications made by patients as a direct impact of Nivolumab economic downturn included delaying or cancelling a routine health care visit (17%), skipping or reducing a dose (12%) and skipping filling a prescription (10%). Although almost Chlormezanone all 48 HCPs considered clinical factors when making treatment decisions, 40 of the 48 HCPs (83%) also indicated that non-clinical (i.e. economic) factors were considered when making treatment recommendations. For patients who had financial difficulties, the most common treatment modifications considered by HCPs for these patients were as follows: delaying an elective surgery (25%), switching from a higher to lower

priced product (21%), delaying start of prophylaxis (15%) and switching from a recombinant to a plasma-derived product (15%). From 2009 to 2010, 78 of 134 (58%) patients reported a ‘slight’ (39%) or ‘significant’ (19%) increase in their health insurance premium. In addition, nine of 134 (7%) patients were unable to obtain health coverage in 2010. Five of these nine patients cited haemophilia A as the reason. However, in 2011, three of them were able to obtain insurance through a state high-risk pool, three through Medicaid, two through Medicare and one through private insurance. The majority of patients (121 of 134) had OOP costs in 2010. However, only 49 of these 121 patients (40%) received assistance with OOP expenses from some patient assistance programmes.

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