Evidence map›Paper›PMID 40795232›Full record

ArticleBlood advances2025

Emicizumab for preventing intracranial hemorrhage in infants with severe hemophilia A: a cost-effectiveness analysis.

Samira Glaeser-Khan, Satoko Ito, Manraj Sra, Rhys Richmond, Robert D Bona, Harlan M Krumholz, Stacy E Croteau, Adam Cuker, George Goshua

Abstract read
In one paragraph

Article in Blood advances, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. When and How to Start Prophylaxis in Children with Hemophilia.Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie · 2026
    Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Samira Glaeser-KhanYale School of Medicine, New Haven, CT.ORCID 0009-0004-7630-9992
Satoko ItoSection of Medical Oncology and Hematology, Department of Internal Medicine, Yale School of Medicine, Yale Cancer Center, and Yale Hemophilia Treatment Center, New Haven, CT.ORCID 0000-0003-4430-1860
Manraj SraDivision of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
Rhys RichmondYale School of Medicine, New Haven, CT.
Robert D BonaSection of Medical Oncology and Hematology, Department of Internal Medicine, Yale School of Medicine, Yale Cancer Center, and Yale Hemophilia Treatment Center, New Haven, CT.ORCID 0009-0001-4600-1493
Harlan M KrumholzCenter for Outcomes Research and Evaluation, Yale University and Yale New Haven Hospital, New Haven, CT.ORCID 0000-0003-2046-127X
Stacy E CroteauPediatric Hematology-Oncology, Boston Children's Hospital, Harvard Medical School, Boston, MA.ORCID 0000-0001-6112-6166
Adam CukerDepartment of Medicine and Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA.
George GoshuaSection of Medical Oncology and Hematology, Department of Internal Medicine, Yale School of Medicine, Yale Cancer Center, and Yale Hemophilia Treatment Center, New Haven, CT.ORCID 0000-0002-1624-4427

Funding

Yale Pathology Tissue Services Shared ResourceP30CA016359 · NCI · YALE UNIVERSITY · PI Eric P. Winer · 1985 to 2026
$85.0M
Targeted, adaptive and time-variant strategies for bleed prevention across the lifespan for persons with hemophilia AK01HL175220 · NHLBI · YALE UNIVERSITY · PI George Goshua · 2024 to 2026
$520k
NCI NIH HHS P30 CA016359NHLBI NIH HHS K01 HL175220
6 · The paper itself

Abstract

abstractIntracranial hemorrhage (ICH) and resulting neurologic disability are severe complications for a subset of infants with severe hemophilia A (HA). Although prophylactic factor replacement reduces bleeding risk, it is typically delayed until after age 1 year due to risks associated with central venous access placement. Emicizumab, a subcutaneous activated factor VIII (FVIII) mimetic, has demonstrated safety and efficacy in preventing ICH in infants aged <12 months in the HAVEN 7 trial. Despite its high cost, the cost-effectiveness of emicizumab prophylaxis initiated during the first year of life for infants with severe HA is not known. We developed a Markov cohort model to compare emicizumab prophylaxis to standard care (no prophylaxis) in infants aged 0 to 1 year with severe HA without FVIII inhibitors. The analysis was conducted from a US societal perspective over a lifetime horizon across all accepted willingness-to-pay (WTP) thresholds. The primary outcome was the incremental cost-effectiveness ratio (ICER) in US dollar per quality-adjusted life-year (QALY). Emicizumab prophylaxis and standard care accrued 25.6 and 25.1 QALYs at costs of $13.12 million and $13.07 million, respectively, resulting in an ICER of $99 900 per QALY (95% credible interval [CI], 84 000-120 000). Scenario analysis examining prophylaxis with low-dose emicizumab resulted in an ICER of $19 600 per QALY (95% CI, 12 000-29 000). Probabilistic sensitivity analyses showed that standard-dose emicizumab is the cost-effective strategy in 100%, 66%, and 0% of 10 000 Monte Carlo iterations at WTP thresholds of $150 000, $104 000, and $50 000 per QALY, respectively, and in 100% across all WTP thresholds for low-dose emicizumab.

Indexed as

Antibodies, BispecificAntibodies, Monoclonal, HumanizedHemophilia AIntracranial HemorrhagesCost-Benefit AnalysisCost-Effectiveness AnalysisHumansInfantInfant, NewbornMaleMarkov ChainsQuality-Adjusted Life YearsAntibodies, BispecificAntibodies, Monoclonal, Humanizedemicizumab

Identifiers

PMID40795232
PMCPMC12744270

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.