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# Hemgenix for haemophilia B costs more than factor IX prophylaxis over the first ten years
- URL: https://www.coios.me/hemgenix-for-haemophilia-b-costs-more-than-factor-ix/
- Published: 2026-10-31T11:16:16.000Z
- Updated: 2026-11-01T07:06:36.000Z
- Description: In a Swedish budget-impact model, Hemgenix cost more than factor IX prophylaxis over 10 years under every payment model.
- Author: Daniel Ryan
- Tags: Data, models and systems, Value in health, Innovation in treatment, Sweden, #peer-reviewed, #refines, #item, #source-2026-10, #score-66

This budget-impact study modelled 5-, 10- and 15-year payer costs of etranacogene dezaparvovec (Hemgenix) in Swedish adults with haemophilia B. A cohort Markov model compared full upfront, 30% reduced upfront and outcome-based annuity payment against factor IX prophylaxis. Scenarios covered short-term trial outcomes, full response, and partial response with a 10% annual failure rate. Hemgenix cost more than prophylaxis for the first 10 years under every scenario and payment model. At 15 years, reduced upfront payment cost least with sustained full response; annuities cost least with partial response. The cohort was hypothetical, and the annuity advantage under partial response disappeared after 3% annual discounting.

*Why it is interesting: Single-dose gene therapies put their cost up front, while their benefit depends on uncertain long-term durability. This study shows how far the payment model and the discount rate change which option costs payers least.*

Source

[Applied Health Economics and Health Policy, 26 October 2026](https://doi.org/10.1007/s40258-026-01077-9?ref=coios.me)

Paper

Financing High-Cost Gene Therapy Under Clinical Uncertainty: Assessing Budget Impact of Reimbursement Models for Hemgenix<sup>®</sup> in Hemophilia B in Sweden

Authors

Padhy S, Johansson P

DOI

10.1007/s40258-026-01077-9

Type

Peer-reviewed article

Design

Cohort Markov budget-impact simulation, hypothetical adult haemophilia B cohort, three reimbursement models over 5/10/15-year horizons with one-way sensitivity analyses

Verdict

Refines prior evidence

Driver

[Value in health](https://www.coios.me/d-health-economics/)

Driver

[Innovation in treatment](https://www.coios.me/d-treatment-innovation/)

Free full text

[Free to read at the publisher](https://doi.org/10.1007/s40258-026-01077-9?ref=coios.me)