Table 3.

Final HTC- and Payer-Reported Metrics for Use in Pilot Programs

Payer-Reported Metrics	HTC-Reported Metrics
Cost of factor ● Total factor cost ● Total factor cost per patient ● Site of care  ∘Facility (hospital/ED)  ∘Ambulatory (infusion center, physician’s office, HTC)  ∘Home/self	Patient classification ● Diagnosis (A or B)  ∘Severity (mild, moderate, or severe)  ∘Inhibitor status (yes or no)
Prescribed dose/dispensed dose/weight (± range) when dispensed via a specialty pharmacy ● Product ● Total units ● U/kg ● Units dispensed ● Prescribed dose/dispensed dose  ∘±10% according to MASAC guidelines; payers desire ±5%	Prescribed dose/dispensed dose/weight (± range) when dispensed at an integrated HTC pharmacy ● Product ● Total units ● U/kg ● Units dispensed ● Prescribed dose/dispensed dose  ∘±10% according to MASAC guidelines; payers desire ±5%
ED visits/hospitalizations ● With hemophilia listed as first/second diagnosis code (ie, in first 2  lines of claim)	ED visits/hospitalizations ● With hemophilia listed as first/second diagnosis code (ie, in first 2 lines of  claim)
Total cost per patient ● Total cost of pharmacy claims ● All other medical claims costs ● Total cost per patient	Home infusion ● PWH/families independently infusing at home (%) ● PWH/families infusing at home with nursing assistance (%)
	Patient contacts (eg, in person, telephone, e-mail) ● Comprehensive care visits ● Other visits ● Case management contacts ● Collaboration with other providers

Notes: Reproduced from Tarantino MD, Pindolia VK. Hemophilia management via data collection and reporting: initial findings from the Comprehensive Care Sustainability Collaborative. J Manag Care Spec Pharm. 2017;23(1):51–56. Available from: https://www.jmcp.org/doi/10.18553/jmcp.2017.23.1.51.⁵⁹Abbreviations: ED, emergency department; HTC, Hemophilia Treatment Center; MASAC, Medical and Scientific Advisory Council; PWH, person/people with hemophilia.