Hemophilia Management


Expert Interview

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Hemophilia Quick Facts

Bleeding Disorders among Women

  • Bleeding disorders are particularly burdensome for females due to the monthly occurrence of menstrual periods and implications for reproductive health; menstruation, pregnancy, and childbirth represent recurrent hemostatic challenges to women with bleeding disorders.
  • Bleeding disorders in women may be associated with an increased incidence of ovarian cysts, endometriosis, miscarriage, bleeding complications during pregnancy, and postpartum hemorrhage (PPH), which may necessitate a blood transfusion, hemostatic therapy, and even hysterectomy in severe cases.
  • Women with bleeding disorders are more likely to experience PPH and are characterized by a maternal mortality rate 10 times higher than women without bleeding disorders.
  • Females are treated similarly to males with bleeding disorders, adjusting the dosing range and schedule based on disease severity and type of bleeding episode.
  • Clotting factor concentrate or recombinant clotting factor concentrate may be prescribed for those carrier females with clotting factors levels <50% of normal, typically in alignment with treatment protocols for mild hemophilia A or B.
  • Considering these diverse physical and psychological complications associated with bleeding disorders in women, expert disease management is best delivered via the comprehensive care model through a hemophilia treatment center (HTC).

Byams VR, Kouides, PA, Kulkarni R, et al. Surveillance of female patients with inherited bleeding disorders in United States Haemophilia Treatment Centres. Haemophilia. 2011;17:6–13.
James AH, Jamison MG. Bleeding events and other complications during pregnancy and childbirth in women with von Willebrand disease. J Thromb Haemost. 2007;5:1165–1169.
Centers for Disease Control and Prevention. Hemophilia treatment centers (HTCs). http://www.cdc.gov/ncbddd/hemophilia/htc.html.


Q: With which type of organization are you affiliated?

Q: What best describes your primary role at this organization?

Q: Approximately how many patients with hemophilia are currently being managed in your plan or practice setting?

Q: Does your organization have a hemophilia therapy management program or policy?

Q: Does your organization contract with the hemophilia treatment center(s) within your coverage area for pharmacy and/or medical services?

Advisory Board

Jennifer Maahs, RN, PNP, MSN
Nurse Practitioner
Indiana Hemophilia and Thrombosis Center

Vanita K. Pindolia, PharmD, BCPS
Vice President, Ambulatory Clinical Pharmacy Programs_PCM
Henry Ford Health System/Health Alliance Plan of Michigan

Steven W. Pipe, MD
Director, Division of Pediatric Hematology and Oncology
Pediatric Medical Director, Hemophilia and Coagulation Disorders Program
University of Michigan

Marion Koerper, MD Professor Emerita on Recall
Department of Pediatric Hematology
School of Medicine University of California, San Francisco
(UCSF) School of Medicine
Medical Advisor
National Hemophilia Foundation

Diane J. Nugent, MD Chair, Hematology
Medical Director, Hematology and Blood and Donor Services
Division Chief, Hematology
Children’s Hospital of Orange County

Celynda G. Tadlock, PharmD, MBA
Vice President Pharmacy Business Development, Aetna
President, Coventry Prescription Management Serivces, Inc.