Lessons from Hemophilia

Patients with genetic diseases have long presented a therapeutic and financial challenge to the health-care system.¹ With the advent of cryoprecipitates of plasma that contain concentrated factor VIII, physicians caring for patients with hemophilia began to explore new ways to manage this chronic disease.¹ Comprehensive centers were built on a multidisciplinary approach and linked to community services.¹ As patients and families became better educated, they learned self-administration of blood products outside the hospital.¹ Many hospitalized patients would then be transferred to an ambulatory setting for medical care. However, since reimbursement was mainly limited to in-hospital care, these programs could not.