Hemophilia A patients are a heterogeneous cohort. The tendency to bleed is highly individual, resulting in a complex management landscape. Two core therapeutic approaches are used: (1) prophylaxis, where the aim is to prevent clinically meaningful bleeds through maintaining factor VIII (FVIII) levels and (2) on-demand treatment, where drugs are used at the time of a significant bleed. Various similar FVIII replacement therapies are available (e.g., Takeda’s Advate, Sanofi’s Elocta). However, some patients develop inhibitors (alloantibodies) that can reduce the effectiveness of FVIII replacement. The launch of Genentech’s novel subcutaneous therapy Hemlibra has impacted the hemophilia A +/- inhibitors markets in differing ways. In the noninhibitor space, compelling reasons exist for many hemophilia A patients to remain on FVIII replacement therapies. In contrast, Hemlibra has dramatically altered treatment dynamics in the inhibitor space and has spurred much discussion about its merits in the management of newly diagnosed inhibitor patients.


  • Are physicians more likely to begin a previously untreated hemophilia A patient on FVIII replacement or Genentech’s Hemlibra, and what is the rationale behind their decision?
  • How do physicians initially manage newly diagnosed high-titer inhibitor patients? What percentage of Hemlibra inhibitor patients are considered to be poor responders?
  • What are the branded patient shares of agents like Takeda’s Adynovi, Bayer’s Kovaltry, and Novo Nordisk’s NovoSeven?
  • How do different product types compare in average weekly units/kg dosing and number of weekly infusions?


Geographies: France, Germany, Italy, Spain, United Kingdom.

Primary research: Survey of 217 European hematologists.

Key drugs covered: Advate, Adynovi, Afstyla, Elocta, Esperoct, FEIBA, Hemlibra, Jivi, Kogenate, Kovaltry, Novoeight, NovoSeven, Nuwiq, Recombinate, Refacto.


Current Treatment: Physician Insights provides physician insights on treatment dynamics, prescribing behavior, and drivers of brand use so that marketers can create specific messaging around these treatment dynamics to more effectively increase or defend their market position.

Table of contents

  • Hemophilia - Current Treatment - Detailed, Expanded Analysis (EU)
    • Current Treatment Physician Insights - Hemophilia A - EU - June 2021

Author(s): Rameshwar Prajapati, Ph.D., M.S. (Pharm.)

Rameshwar Prajapati, M.S.(Pharm.), Ph.D., is an analyst on the Cardiovascular, Metabolic, Renal, and Hematologic (CMRH) Disorders team at Clarivate. He focuses on the treatment of obesity and peripheral arterial disease but has also authored content on other cardiovascular, renal, and metabolic indications. Dr. Prajapati earned a bachelor’s degree in pharmacy from Hari Singh Gour University and a master’s degree and Ph.D. in pharmacoinformatics from the National Institute of Pharmaceutical Education and Research, S.A.S. Nagar India.

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