Hemophilia and von Willebrand's disease: 2. Management

Table 1: Coagulation-factor concentrates used in Canada for the management of hemophelia*
Factor concentrate	Manufacturer	Viral inactivation procedure	Purity standard	Maximum specific activity, IU/mg protein	BOB licensed	Funded by CBA and available through CRC	Cost per unit+
Factor VIII
Factor VII HP	CRC-Bayer	Solvent-detergent treatment	High	50-60~	Yes	Yes	0.20
Hemofil M	Baxter	Solvent-detergent treatment	Ultra high	>= 3000~	Yes	Yes	0.76
Kogenate	Bayer	No specific step§	Recombinant	>= 3000~	Yes	Yes	0.75
Recombinate	Baxter	No specific step§	Recombinant	>= 3000~	Yes	No||	1.06
Haemate P	Behring	Pasteurization	Intermediate	2.3-5	No¶	Yes	1.00
Hyate:C (porcine Factor VIII)	Speywood	No specific step	High	>= 140	Yes	Yes	1.35
Factor IX (prothrombin complex)
Bebulin	Immuno	Vapour heating	Intermediate	1-3	Yes	Yes	0.26
FEIBA	Immuno	Vapour heating	Low to intermediate	0.75-2.5	Yes	Yes	1.02
Factor IX (high purity)
Alphanine SD	Alpha	Solvent-detergent treatment	High	182 ± 34	No¶	Yes	0.58
Immunine	Immuno	Vapour heating	High	100 ± 50	No¶	Yes	0.58
Mononine	Armour	Sodium thiocyanate treatment plus ultrafiltration	High	188 ± 14	No	No||	0.74
Factor VIIa
Niastase	Novo Nordisk	No specific step	Recombinant	NA	No	No**	NA

*BOB=Bureau of Biologics, CBA=Canadian Blood Agency, CRC=Canadian Red Cross Society Blood Services, NA=not available
+In Canadian dollars as of February 1995. Cost will vary according to contracts and availability.
~Before human albumin is added as a stabilizer. The specific activity in the final formulation containing added human albumin is much less.
§Specific viral inactivation procedures are not used, but some of the manufacturing or purification steps have virus reduction or removal capability.
||May be obtained by special application when adverse reactions to equivalent products occur.
¶BOB licensure has been applied for. **May be obtained for specific patients on compassionate release basis.