Factor VIII Concentrates - Forces of Supply and Demand
Some surprisingly simple artificial factors influence the availability of factor VIII for hemophilia treatment. Demand is affected by choice of product, and choice of treatment style (episodic vs. prophylactic), and also by availability funds.Autobiographic data suggest the feasibility of long-term low dosage prophylaxis (6u/KgA8 hrs.). This tentative conclusion is based on 2½yrs. of unprecedented near-total freedom from hemorrhage. The significance is the potential saving of 60% of factor VIII concentrate, compared with the more orthodox dose (15u/KgA8 hrs.) which has been shown to increase factor VIII usage by 2.5–3 times compared with episodic therapy.The American Red Cross produced 293,332 units of cryoprecipitate from 4,690,217 whole blood donations in 1975-6 (6.25% of blood collected). Production could readily be increased if the demand existed. The following artificial factors have an influence on cryoprecipitate production: health insurance policies; price structure; the international market for factor VIII.It is concluded that there is no shortage of available factor VIII, that more could readily be made available, that prophylaxis may be possible without increasing demand for factor VIM, that financial considerations are seriously distorting hemophi1ia treatment, that hemophilia treatment in the United States is being subsidised by other countries, and that understanding of these factors can help to overcome them.