Influence of medical insurance schemes and charity assistance projects on regular prophylaxis treatment of the boys with severe haemophilia A in China

Li, Z.; Wu, Jing; Zhao, Yongqiang; Liu, Runhan; Li, K.; Zhou, Yin; Wu, Runhui; Yang, Renchi; Zhang, X.; Lian, Shinmei; Hu, Qun; Li, X.; Gu, J-M.; Zhou, Rong-Fu; Sun, Jing; Li, C.; Xu, Weiqun; Poon, Man‐Chiu

doi:10.1111/hae.13372

Cited by 11 publications

(16 citation statements)

References 22 publications

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“…In 2017, the Haemophilia Experience, Results and Opportunity (HERO) study compared quality of life of PWH in China with nine other countries; results showed that PWH in China had lower rates of employment, prophylaxis treatment, and experienced greater difficulties in obtaining replacement factors, and timely treatment 48 . Furthermore, although the overall proportion of reimbursement for haemophilia has improved, it is not consistent across provinces/locations and has been reported, ranges from 40% to 94% 16 . This is because specific provisions for medical insurance are formulated and executed at the local government levels, and the reimbursement proportion is usually lower in those economically less developed provinces/locations.…”

Section: Discussionmentioning

confidence: 99%

“…The increase in the reimbursement ratio and extension of health insurance coverage for haemophilia since 2004 represent an important milestone for PWH in China. A retrospective study of 12 centres in China showed that with the improvement of local medical insurance policies, the average duration of prophylaxis received by children with haemophilia increased from 16.7 weeks in 2008 to 32.8 weeks in 2012 16 …”

Section: Achievements In Capacity Building and Development Of A Haemomentioning

confidence: 99%

“…Despite improvements in medical insurance coverage and expanded product options, clotting factor concentrates remain unaffordable. Costs covered by insurance vary widely (40%‐94% 16 ) among cities with differing economies, and the out‐of‐pocket expense is a continual challenge for many patients. As a result, full‐dose prophylaxis in use in the west is unattainable for most patients in China.…”

Section: Achievements In the Clinical Evaluation And Treatment Of Haementioning

confidence: 99%

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Haemophilia care in China: Achievements in the past decade

2020

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There is a large population of people with haemophilia in China. However, the development of haemophilia care in China lagged far behind developed countries and was unbalanced across different regions. With the establishment of the Hemophilia Treatment Center Collaborative Network of China (HTCCNC) in 2004 and its collaboration with the Chinese government, the World Federation of Haemophilia (WFH), non-profit foundations, industries, and experts from other countries, haemophilia care in China have made considerable strides in building capacity. The HTCCNC helped develop clinics throughout the country, promote multidisciplinary care, promote prophylaxis (albeit low-dose), advance clinical evaluation and treatment, and research. With many collaborative efforts in the past decade, haemophilia care in China has entered a new stage of development. In this review, we summarize these major achievements and efforts within the last decade.

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Section: Discussionmentioning

confidence: 99%

Section: Achievements In Capacity Building and Development Of A Haemomentioning

confidence: 99%

Section: Achievements In the Clinical Evaluation And Treatment Of Haementioning

confidence: 99%

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Haemophilia care in China: Achievements in the past decade

2020

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“…Other important QoL parameters such as education and employment attendance, community engagement, as well as patient‐reported outcomes will need to be assessed in future studies. Third, the initiation and the length of prophylaxis were heterogeneous, when and how long the patient would be on prophylaxis mainly depended on their ability to afford the out‐of‐pocket payment beyond their insurance coverage 28 . It is noteworthy that no children had prophylaxis beyond 30 months over the 6‐year (72‐month) period and that the points of time of actual initiation of prophylaxis varied.…”

Section: Discussionmentioning

confidence: 99%

Severe haemophilia A children on low‐dose tertiary prophylaxis showed less joint deterioration and better maintenance of functional independence than children on on‐demand treatment: A 6‐year follow‐up study

Liu

Chen

et al. 2020

Haemophilia

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Background: In countries with limited resource, haemophilia patients have to choose low-dose prophylaxis or on-demand treatment (ODT) because of economic constraints. Whether low-dose prophylaxis can achieve better joint function outcome than ODT over long-term remains unclear. Aim: To investigate the long-term effect of low-dose tertiary prophylaxis versus ODT on joint health in severe haemophilia A children. Methods: This was a retrospective study. We enrolled and followed 34 severe haemophilia boys in China receiving on-demand treatment (n = 18) or low-dose prophylaxis (10-15 IU/kg, 2-3 times per week) for a medium-term (6-18 months, n = 9) or longer-term (19-30 months, n = 7). We evaluated their haemophilia joint health score (HJHS) 2.1 and functional independence score in haemophilia (FISH) at baseline and at their 6-year follow-up visits. Their annual bleeding rate (ABR) and annual joint bleeding rate (AJBR) were also recorded. Results: During the 6-year follow-up period, ABR and AJBR were similar between the 2 prophylaxis groups, with each of the 2 prophylaxis group rates being significantly better (lower) than the ODT group (P < .05). Compared to baseline values, evaluation at 6-year follow-up showed HJHS improvement in both prophylaxis groups, although significantly (P < .05) only in the longer-term prophylaxis group. The FISH score showed insignificant change in patients in each prophylaxis cohort, compared to significant worsening (P < .05) in the ODT group. Conclusion: Low-dose tertiary prophylaxis reduced ABR and AJBR of children with severe haemophilia and better maintained their functional independence by the FISH over the long term. Longer-term prophylaxis also improved their joint health status by the HJHS.

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“…Similar findings were reported by Yu et al 23 A major reason was the lower reimbursement rates for NRCMS compared with URBMS. Li et al 24 explored the influence of medical insurance policy on the regular prophylaxis treatment in Chinese children with severe hemophilia A and found groups receiving higher reimbursement proportion were more likely to have higher medication consumption. Similarly occurs for corrective surgery, which costs have increased substantially with the application of advanced technology such as pedicle screw constructs, blood salvage techniques, and intraoperative cord monitoring.…”

Section: Discussionmentioning

confidence: 99%

Influence of Insurance Status on Curve Magnitude in Adolescent Idiopathic Scoliosis in Mainland China

Lin

Meng

Yin

et al. 2019

Global Spine Journal

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Study Design: Retrospective cohort study. Objectives: To determine whether there is an association between insurance status and curve magnitude in idiopathic scoliosis pediatric patients in mainland China. Methods: Medical records of patients with adolescent idiopathic scoliosis in 4 tertiary spine centers across China from January 2013 to December 2017 were analyzed. Data was extracted on insurance status, curve magnitude, recommended treatment at presentation, source of referral, and treatment initiated. Additional information was collected for patients requiring corrective surgery, including time from recommendation for surgery to surgery and clinically relevant parameters such as, postoperative complications, and pre-/postoperative Scoliosis Research Society–22 scores were also collected for patients requiring corrective surgery. Results: Of the 1785 patients included, 1032 were Urban Resident Basic Medical Insurance Scheme (URBMS) insured and 753 were New Rural Cooperative Medical Scheme (NRCMS) insured. NRCMS patients presented with a larger major curve than URBMS patients (32.9° ± 15.1° vs 29.3° ± 12.6°, P = .028). For patients having surgery recommended, NRCMS patients presented with a larger mean Cobb angle at the first presentation (57.7° vs 50.9°, P < .0001) and at time of surgery (61.3° vs 52.2°, P < .0001), and experienced a significantly longer time from surgery recommendation to decision for surgery. Complication rates were comparable between the 2 groups, except for pulmonary complications (NRCMS 7.3% vs URBMS 2.8%, P = .04). Postoperatively, patients covered by NRCMS insurance experienced greater overall improvement in health-related quality of life and were less satisfied with the treatments. Conclusions: This study shows that health insurance may influence the severity of scoliosis on presentation, with implications on early diagnosis and surgery time.

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Influence of medical insurance schemes and charity assistance projects on regular prophylaxis treatment of the boys with severe haemophilia A in China

Cited by 11 publications

References 22 publications

Haemophilia care in China: Achievements in the past decade

Haemophilia care in China: Achievements in the past decade

Severe haemophilia A children on low‐dose tertiary prophylaxis showed less joint deterioration and better maintenance of functional independence than children on on‐demand treatment: A 6‐year follow‐up study

Influence of Insurance Status on Curve Magnitude in Adolescent Idiopathic Scoliosis in Mainland China

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