We conducted a cost-minimization design study to determine the most cost-effective clotting factor management strategy for patients receiving prophylactic treatment. We compared the pre-intervention strategy, current model of care without pharmacist involvement, to the post- intervention strategy, model of care that included pharmacist interventions and support. We assumed that the effectiveness of both strategies was the same. The study was conducted from the perspective of the formulary manager, Canadian Blood Services, with a one-year time horizon.

Only drug prices were considered since it has been shown that more than 97% of the cost is due to clotting factor replacement¹⁰. Other sources of costs, such as drug administration and storage costs, do not substantially impact on the overall cost. Due to the confidential nature of the cost of coagulation factors, the financial calculation was done by Canadian Blood Services. The unit cost of each product was used and then multiplied by the units projected to be consumed annually for each patient. Since the unit costs are proprietary information, the doses and unit costs will not be disclosed, only the annual cost savings per patient will be reported. We assumed that the annual salary of a pharmacist is $130K CAD.