HEMOPHILIA-A

HEMLIBRA
HETANG DESAI
INDEX

 What is Hemophilia
 Current Treatment Options
 Patient Funnel
 Commercial Attractiveness
 Barriers
 Portfolio Fitment
 Marketing Strategy
WHAT IS HEMOPHILIA

 A medical condition in which the ability of the blood to clot is severely reduced, causing
the sufferer to bleed severely from even a slight injury.

 The condition is typically caused by a hereditary lack of a coagulation factor, most often
factor VIII.

 World wide incidences: Hemophilia is quite rare. About 1 in 10,000 people are born with it.
SEVERITY OF HEMOPHILIA-A

Percentage of normal factor Number of international units (IU) per

Level
activity in blood milli litre (ml) of whole blood

Normal range 50%-150% 0.50–1.5 IU

Mild hemophilia 5%-40% 0.05–0.40 IU

Moderate hemophilia 1%-5% 0.01–0.05 IU

Severe hemophilia less than 1% less than 0.01 IU

CURRENT TREATMENT

 Factor concentrates are the treatment of choice for hemophilia. They can be made from
human blood (called plasma-derived products) or manufactured using genetically
engineered cells that carry a human factor gene (called recombinant products).

 Cryoprecipitate is derived from blood and contains a moderately high concentration of

clotting factor VIII (but not IX). It is effective for joint and muscle bleeds

 In fresh frozen plasma (FFP) the red cells have been removed, leaving the blood proteins
including clotting factors VIII and IX. It is less effective than cryoprecipitate for the
treatment of hemophilia A because the factor VIII is less concentrated

 Desmopressin (also called DDAVP) to treat minor bleeding. DDAVP is a synthetic

hormone that stimulates the release of factor VIII.
COMPETITION
PATIENT FUNNEL
India Population (2019) 1,373,564,332

Male: Female Ratio (52.6:48.4)

722,494,839

Disease Prevalence (Global) 400,000

India Prevalence (Estimated)
(1:5000) 144,500
Hemophilia A :
Hemophilia B (4:1) 115,600

Registered 20,839
Patients (India)
Prophylaxis 7,710
(37%)
COMMERCIAL ATTRACTIVE

 Around 280 crore market for factor VIII concentrates in India

 Increased funding for government sources for research and awareness
 Increased funding from WHF (World Hemophilia Federation) to Hemophilia
Federation of India
 HFI coverage extended to 21 states and 20837 patients.
 95,000 patients currently not reached
BARRIERS

 High cost of treatment for Prophylaxis

 High out of pocket expenditure
 Lack of infrastructure and technical knowledge of caregivers as well as patients
 Equity and Association of Novo Nordisk & Shire with HFI
PORTFOLIO FITMENT

 Current Portfolio of Roche includes:

 Oncology
 Transplantation
 Rheumatoid Arthritis
 Personalized Healthcare
 Cancer immunotherapy
 Anaemia
MARKETING STRATEGY

 Each Patient Matters!

 Run social media campaigns to create disease awareness and improve patient
compliance.
 Leverage equity with WHF and enter into an association with HFI
 Lobby the government to increase allocation of budget on Hemophilia awareness
and treatment
 Organise CME & Round Table conferences along with HFI.
 Move existing Rxers of factor VIII products by communicating enhanced benefits
and fast track US approval.
THANK YOU!