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Hemophilia treatment could get cheaper

Dipesh Satapathy in Montreal

An Indian expert has claimed that dosages of blood-derived factors lower than that usually administered to hemophiliac patients can be equally effective.

Dr Alok Srivastava from Christian Medical College, Vellore, told the 24th World Hemophilia Congress in Montreal on Wednesday that infusing 250-300 international units per kilogram weight of a person (iu/kg) instead of 800-1000 iu/kg generally given in affluent countries, could be equally effective in treating hemophiliacs.

Hemophilia, a genetic disorder caused only in men due to absence of certain clotting factors in the blood, is treated by replacing the deficient factors derived either from blood plasma or synthetically through genetic engineering.

Factor replacement is required for hemophiliacs either during surgery or during continual bouts of internal bleeding into joints and muscles that lead to pain, stiffness, aches and even disability if left untreated.

Prohibitively high cost has always been a major barrier in the use of anti-haemophilia factors in developing nations, Srivastava said.

Using the lower dose protocol that CMC has developed, doctors could perform surgeries on 114 patients between 1984 and 1999 without major complications, Srivastava said.

"It is possible to reduce total factor consumption for major surgeries in severe hemophilia patients to around 300 iu/kg per procedure from the usual 600-1000 iu/kg used in advanced nations," he said.

Meanwhile, the World Federation of Hemophilia praised the organization and treatment procedure for hemophilia in India. It said that 12 per cent of all probable hemophiliacs in the country get accurately diagnosed.

Compared to this, in Indonesia and China, which have a higher gross national products than India, only three and two per cent respectively of all hemophiliacs are rightly diagnosed, WFH president Brian O'Mahony said, adding, "Their resources are limited, but they make very efficient use of what they have." He was referring in particular to Hemophilia Federation India, the Delhi-based non-governmental organisation.

Malaysia, which unlike India, gets government support for hemophiliacs, also provides sound treatment options for hemophiliacs with an active central organisation and regular training of doctors, he said.

About three-fourth of 300,000 hemophiliacs worldwide go untreated or receive inadequate treatment though the disease is treatable, O'Mahony said. Many, especially those in developing nations, die before the age of 19.

Apart from developed nations that offer excellent hemophilia treatment and care, many developing nations like Brazil, Argentina and South Africa also provide adequate treatment, he said.

PTI

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