Dunia Castillo-González, Instituto de Hematología e Inmunología, La Habana, Cuba
Consuelo M. Macías-Abraham, Instituto de Hematología e Inmunología, La Habana, Cuba
M. Cristina Lara-Bastanzuri, Ministerio de Salud Pública, La Habana, Cuba
Miriam Vilaragut-García, Roche Servicios C.A.C.V. S.A., La Habana, Cuba
Introduction: Emicizumab, marketed in Cuba as Hemcibra® (Hoffmann-La Roche, Basel, Switzerland), was the first innovative therapy approved for the treatment of people with hemophilia A. Objectives: To show the working strategy created for the stable introduction of emicizumab in Cuba, under tight budget conditions. Materials and methods: During 2018 and 2019, a working system was implemented to introduce this drug in Cuban patients with severe bleeding phenotype and complications derived from the disease. Specialists from the Institute of Hematology and Immunology, together with officials from the Ministry of Public Health, designed a strategy that contemplated a set of main actions to achieve this objective. Results: Patients from all provinces throughout the country have been gradually enrolled. 58 patients were receiving treatment until December 2024, 67,2% of those proposed in the initial phase and 12 infants were born with severe hemophilia A during the period 2019-2024. A significant reduction in the annualized bleeding rate was observed in a cohort of 39 patients who completed more than one year of treatment. Conclusions: It has been demonstrated that the rational use of medications and collaborative actions between experts and decision-makers can contribute to improving the health of the at-risk population. This work experience made it possible to reduce healthcare costs and optimize equitable access to medical care.
Keywords: Hemophilia A. Emicizumab. Health strategies. Cuba.