Humanistic and economic aspects of XXXX treatment in Bulgaria. Comparison between two therapeutic approaches: prophylactic vs. on-demand treatment.

@entity1 @entity797 @entity4461 @entity447
UNASSIGNED: The aim of the present study was to calculate the cost-effectiveness of on-demand and prophylactic treatments of severe @entity447 for Bulgarian @entity1 . The point of view is that of all @entity1 suffering from severe @entity447 . An epidemiological model was created, which includes data regarding the number of @entity1 divided into age groups up to 74  years. In the model, the transition age from prophylactic to on-demand treatment was gradually increased to up to 40  years. Costs of @entity4461 factor, hospitalization, major surgery and indirect costs were considered; incremental cost-effectiveness ratio was calculated. The results showed that despite the increase in the costs for factor @entity797 with 20 million BGN, the saving obtained from other health services and indirect expenses reduce the overall expenses with 5.3 million BGN. If there is a gradual increase in the age when @entity1 are transferred from a prophylactic to an on-demand regimen, the costs for factor @entity797 would increase from 10.4 million to 19.7 million BGN, but due to a decrease in indirect costs as well as other health service costs, the total costs would decrease. The sensitivity analysis showed that the costs for clotting factor @entity797 are what influences the cost-effectiveness in both regimes. This indicates that decreases in the factor @entity797 cost will increase the overall efficiency in both regimes. In conclusion, the application of the prophylactic regime for @entity1 up to 40  years of age will provide better treatment, increase the quality of life and decrease the incremental costs.
